Parallel cases of twins developing “symmetrical” dactylitis in two digits following similarly sustained foot injuries support the hypothesis that joint mechanical stress is a major trigger of psoriatic arthritis and dactylitis in genetically susceptible individuals, according to a scientific letter published Jan. 28 in Annals of the Rheumatic Diseases.
A team of researchers led by Dr. Jennifer Ng of Griffith University and Paradise Arthritis and Rheumatology in Southport, Australia, described the cases of identical twins, 54-year old women with a history of psoriasis, both of whom developed psoriatic arthritis of the respective right and left second toes. Both sisters had no arthritis prior to the joint injuries, and one of the patients had to be treated with methotrexate 15 mg weekly with almost complete resolution of the swelling and pain.
Although researchers are still exploring the precise mechanisms that link joint injury and psoriatic arthritis onset, the authors assert they have proof of concept of how site specific injury may result in biomechanical triggering events in genetically susceptible hosts.
Read the entire article here: doi:10.1136/annrheumdis-2014-206784.