Psoriasis as we know is a big risk for developing Psoriatic Arthritis. Clinically reasoning who we send to Rheumatology is a little bit of a challenge however. Do you refer a person with Psoriasis and tendon pain? Or do you need more of an inflammatory picture first? 

We don't want to delay diagnosis but we also don't want to over investigate or over medicalise. I discussed one way in a blog about nails. In this video I discuss a paper that looks at Psoriasis, MSK Pain and Ultrasound. We take some useful ideas from it to help with clinical reasoning.

 Unfortunately the paper is not open access but you can find it here. 

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