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Patellofemoral instability and dysfunction are frequent symptoms in Nail patella syndrome (NPS). In this article, the first large series of NPS patients is presented in which these knee symptoms were assessed using validated outcome scores.
1 Distal psoriatic arthritis: This type causes inflammation and stiffness near the ends of the fingers and toes, along with changes in toenails and fingernails such as pitting, white spots and lifting from the nail bed. 2  Spondylitis: Pain and stiffness in the spine and neck are hallmarks of this form of PsA.