Haydarpasa Numune Med J. Ahead of Print: HNHJ-26576 | DOI: 10.14744/hnhj.2021.26576

A Case of Psoriatic Arthritis with Elbow Involvement Misdiagnosed as Osteomyelitis

Ozge Gulsum Illeez¹, Feyza Unlu Ozkan¹, Kubra Neslihan Kurt Oktay², Fatma Nur Soylu Boy³, Pinar Akpinar¹, Ilknur Aktas^1
1University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul,Turkey
²Yeditepe University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Istanbul,Turkey
³University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Radiology, Istanbul, Turkey

Psoriatic Arthritis is a chronic systemic inflammatory disease characterized by joint inflammation associated with psoriasis and may present with a variety of clinical manifestations related to bone structures and soft tissues around the joints. Psoriatic arthritis may show radiological findings similar to osteomyelitis (OM). A 69-year-old patient who had been diagnosed with psoriatic arthritis for 5 years was referred to our clinic with a preliminary diagnosis of OM due to severe pain in the right elbow. The patient had polyarthralgia and extensive skin involvement. Disease activation was considered as a result of detailed investigations. Both the joint and skin involvement of the patient were controlled with biological agent treatment. Differential diagnosis should be done carefully in patients with arthralgia and/or arthritis. Advanced radiological imaging should be performed.

Keywords: Osteomyelitis, Psoriatic arthritis, Psoriasis.

---

Osteomiyelitle Karýþtýrýlan Dirsek Tutulumlu Bir Psöriatik Artrit Vakasý

Ozge Gulsum Illeez¹, Feyza Unlu Ozkan¹, Kubra Neslihan Kurt Oktay², Fatma Nur Soylu Boy³, Pinar Akpinar¹, Ilknur Aktas^1
1Saðlýk Bilimleri Üniversitesi, Fatih Sultan Mehmet Eðitim ve Araþtýrma Hastanesi, Fiziksel Týp ve Rehabilitasyon Kliniði, Ýstanbul, Türkiye
²Yeditepe Üniversitesi Týp Fakültesi,Fiziksel Týp ve Rehabilitasyon Kliniði, Ýstanbul, Türkiye
³Saðlýk Bilimleri Üniversitesi, Fatih Sultan Mehmet Eðitim ve Araþtýrma Hastanesi, Radyoloji Kliniði, istanbul, Türkiye

Psöriatik artrit; psöriazis ile iliþkili, eklem inflamasyonuyla karakterize, kronik, sistemik, inflamatuar bir hastalýktýr. Eklem çevresi kemik yapýlar ve yumuþak dokular ile ilgili çok farklý klinik tablolarla karþýmýza çýkabilir. Kemiðin iltihabi bir durumu olan osteomiyelitle radyolojik olarak benzer bulgular gösterebilir. 69 yaþýnda, 5 yýldýr psöriatik artrit tanýsý bulunan hasta, sað dirsekte þiddetli aðrý nedeniyle, osteomyelit ön tanýsý ile tarafýmýza yönlendirildi. Hastanýn poliartrraljisi ve yaygýn cilt tutulumu mevcuttu. Yapýlan ayrýntýlý tetkikler sonucunda hastalýk aktivasyonu düþünüldü. Biyolojik ajan tedavisi ile hastanýn hem eklem hem de cilt tutulumu kontrol altýna alýndý. Artralji ve/veya artritle gelen hastalarda ayýrýcý taný dikkatle yapýlmalý, gerektiðinde ileri tetkiklerden faydalanýlmalýdýr.

Anahtar Kelimeler: Osteomiyelit, Psöriatik artrit, Psöriazis.

---