Finding | Psoriatic arthritis | Rheumatoid arthritis | Lupus | Gout | Ankylosing spondylitis | Reactive arthritis | IBD-associated arthritis (Crohn's / UC) |
---|---|---|---|---|---|---|---|
Age of onset Male:Female |
30 - 40s 1:1 |
35 - 50s 1:3 |
20 - 30s 1:9 |
30 - 60s 3:1 |
17 - 30s 3:1 |
20 - 30s 5:1 |
30s 2:1 |
Distal joints |
Fingers and toes including DIP Asymmetric ≤ 4 joints |
Fingers and toes, spares DIP Symmetric > 4 joints |
Hands, wrists, knees Symmetric > 4 joints |
Great toe, foot, ankle, knees, elbow Asymmetric < 4 joints |
Lower limbs (30 - 50%) Asymmetric < 4 joints |
Knees, ankles, hips Asymmetric < 4 joints |
Hands and knees Asymmetric |
Spine disease | Axial joints - 50% Sacroiliitis - 40% |
Uncommon | Uncommon | Absent | 100% | Sacroiliitis - 50% Back pain - 50% |
30% |
Enthesitis | 30 - 50%, Plantar fascia and Achilles's tendon | Absent | Absent | Absent | Common | Common, Achilles tendon and plantar fascia | Uncommon |
Dactylitis | 40 - 50% | Absent | Absent | Uncommon | Uncommon | Common | Absent |
HLA-B27 positive | 40 - 50% | Not associated | Not associated | Not associated | 90 - 95% | 75% | 30% |
Eye disease | Uveitis - 8% | Dry eyes - 20% | Dry eyes - 15% | Absent | Uveitis - up to 30% | Conjunctivitis (common) Anterior uveitis - 25% |
Uveitis - up to 7% |
Other features | Psoriasis - 100% Nail disease - 85% |
Positive RF and Anti-CCP | Positive ANA Joint disease is non-erosive |
Elevated uric acid | Primarily affects the spine and pelvis | ✝Preceding infection Urethritis (common) Self-limited - 80% |
Occurs in 10 - 20% of patients with IBD |