Psoriatic Arthritis and its Diagnostic Challenge: Case Report

Abstract

Psoriatic arthritis (PA) usually presents as oligoarthritis or monoarthritis and can be a diagnostic challenge in the absence of psoriasis background.
We report the case of a 57-year-old patient who presented to the Family Physician (FF) after one year of inflammatory signs and onycholysis of the 3rd finger of the right hand. Initial exams showed signs of inflammation from the periungueal tissues to the distal interphalangeal joint, and negative analytical inflammatory parameters.
The condition was interpreted in an infectious context and, later, as osteoarthritis, without improvement with the instituted treatments. The disease and the diagnosis delay had significant psychological and professional impact on the patient.
This case reports a rare presentation of PA, that could increase the diagnostic suspicion of this entity in Primary Health Care and highlights the role of the FF in the holistic follow-up and management of patient expectations, besides articulation with other specialties.