{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T16:40:45Z","timestamp":1772901645960,"version":"3.50.1"},"reference-count":80,"publisher":"The Journal of Rheumatology","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>Research on psoriatic arthritis mutilans (PAM), the most severe form of psoriatic arthritis, is impeded by the lack of an accepted classification criteria. We performed a systematic review of the literature to identify and synthesize clinical and radiographic features associated with the definition of PAM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>A systematic literature search limited to human studies was conducted without language restriction. Abstracts were independently screened by 2 investigators and studies that reported information on patients with PAM were included. A standardized form was used to independently collect clinical and radiographic items defining PAM, patient\u2019s demographics, disease characteristics, and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>There were 8570 citations searched to identify 112 articles for full review and 58 articles for data abstraction. We identified 8 definitions of PAM that were used in 283 subjects with a mean age \u00b1 SD at diagnosis of PsA of 33.9 \u00b1 8.2 years. Disease manifestations (prevalence) included dactylitis (29\u201364%), enthesitis (29\u201332%), axial disease (14\u201327%), and nail lesions (47%). PAM definitions include 1 (n = 2 studies) or more (n = 14 studies) joints involving interphalangeal, metacarpophalangeal, or metatarsophalangeal joints. The most prevalent PAM clinical features were digital telescoping (34%), digital shortening (33%), and flail joints (22%). The most prevalent PAM radiographic items were bone resorption (41%), pencil-in-cup change (16%), total joint erosions (14%), ankylosis (21%), and subluxation (7%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>We have identified 8 definitions of PAM, and synthesized the clinical and radiographic items that are important for the classification of PAM. We have established the groundwork for future development classification criteria for PAM.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.141545","type":"journal-article","created":{"date-parts":[[2015,6,16]],"date-time":"2015-06-16T01:12:55Z","timestamp":1434417175000},"page":"1432-1438","source":"Crossref","is-referenced-by-count":25,"title":["Psoriatic Arthritis Mutilans: Clinical and Radiographic Criteria. 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