eMedicine Specialties > Physical Medicine and Rehabilitation > Arthritis & Connective Tissue Disorders

Psoriatic Arthritis: Follow-up

Author: Michael F Saulino, MD, PhD, Assistant Professor, Department of Physical Medicine and Rehabilitation, Thomas Jefferson University, MossRehab
Coauthor(s): Jeffrey M Heftler, MD, Interventional Physiatrist, Orthopaedic and Neurosurgical Specialists, Greenwich, CT
Contributor Information and Disclosures

Updated: Mar 24, 2009

Follow-up

Further Inpatient Care

  • Patients with psoriatic arthritis who have severe destruction of their joints may require surgical intervention and hospitalization, especially if total joint replacement of the hip and/or knee is performed. The inpatient care varies with each individual case and course of hospitalization.

Further Outpatient Care

  • Specific outpatient follow-up care is required for individuals with psoriatic arthritis who undergo surgical repair of their joints. In most cases, conservative treatment is successful and completed in an outpatient setting. Physical and/or occupational therapy is usually recommended, in addition to medications, to minimize pain and stiffness (see Rehabilitation Program).

Prognosis

  • Prognosis is generally good for psoriatic arthritis, with most symptoms controlled with medications, but 25% of patients may have progressive disease.

Patient Education

  • Education is an important component of the patient's treatment plan because he or she must be able to manage the symptoms of psoriatic arthritis (PsA) and be comfortable with self-treatment strategies. Physical therapists provide education and an exercise program developed for each individual patient. Completing the wrong kind of exercise or overexertion can be harmful for patients with PsA.
  • Instructing patients with PsA in methods of joint protection is necessary and becomes part of the therapy process. Patients need to pace themselves and take adequate rest breaks from activity. Other examples of joint protection may include wearing splints on the affected joints, using proper body mechanics and lifting techniques, and assistive devices or adaptive equipment incorporated into activities of daily living.
  • For excellent patient education resources, visit eMedicine's Psoriasis Center and Arthritis Center. Also, see eMedicine's patient education articles Psoriatic Arthritis, Psoriasis, and Psoriasis Medications.

Miscellaneous

Medicolegal Pitfalls

  • Given the complexity of DMARD therapy, patients with psoriatic arthritis should be followed simultaneously by a rheumatologist and physiatrist. In addition, consultation with an orthopedic surgeon is warranted for individuals who may benefit from joint replacement, arthrodesis, or contracture release.
 


More on Psoriatic Arthritis

Overview: Psoriatic Arthritis
Differential Diagnoses & Workup: Psoriatic Arthritis
Treatment & Medication: Psoriatic Arthritis
Follow-up: Psoriatic Arthritis
Multimedia: Psoriatic Arthritis
References
Further Reading
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References

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Contributor Information and Disclosures

Author

Michael F Saulino, MD, PhD, Assistant Professor, Department of Physical Medicine and Rehabilitation, Thomas Jefferson University, MossRehab
Michael F Saulino, MD, PhD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, and Physiatric Association of Spine, Sports and Occupational Rehabilitation
Disclosure: Nothing to disclose.

Coauthor(s)

Jeffrey M Heftler, MD, Interventional Physiatrist, Orthopaedic and Neurosurgical Specialists, Greenwich, CT
Jeffrey M Heftler, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Rajesh R Yadav, MD, Assistant Professor, Section of Physical Medicine and Rehabilitation, MD Anderson Cancer Center, University of Texas at Houston
Rajesh R Yadav, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Patrick M Foye, MD, FAAPMR, FAAEM, Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School
Patrick M Foye, MD, FAAPMR, FAAEM is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society
Disclosure: Nothing to disclose.

CME Editor

Kelly L Allen, MD, Regional Medical Director, IMX-Medical Management Services
Disclosure: Nothing to disclose.

Chief Editor

Denise I Campagnolo, MD, MS, Director of Multiple Sclerosis Clinical Research and Staff Physiatrist, Barrow Neurology Clinics, St Joseph's Hospital and Medical Center; Investigator for Barrow Neurology Clinics; Director, NARCOMS Project for Consortium of MS Centers
Denise I Campagnolo, MD, MS is a member of the following medical societies: Alpha Omega Alpha, American Association of Neuromuscular and Electrodiagnostic Medicine, American Paraplegia Society, Association of Academic Physiatrists, and Consortium of Multiple Sclerosis Centers
Disclosure: Teva Neuroscience Honoraria Speaking and teaching; Serono-Pfizer Honoraria Speaking and teaching

 
 
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