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Diagnostic imaging of psoriatic arthritis. Part I: etiopathogenesis, classifications and radiographic features.

Sudoł-Szopińska I, Matuszewska G, Kwiatkowska B, Pracoń G - J Ultrason (2016)

Bottom Line: In this part of the paper we discuss radiographic features of the disease.The next one will address magnetic resonance imaging and ultrasonography.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Radiology Department, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland; Department of Diagnostic Imaging, Second Faculty, Warsaw Medical University, Warsaw, Poland.

ABSTRACT
Psoriatic arthritis is one of the spondyloarthritis. It is a disease of clinical heterogenicity, which may affect peripheral joints, as well as axial spine, with presence of inflammatory lesions in soft tissue, in a form of dactylitis and enthesopathy. Plain radiography remains the basic imaging modality for PsA diagnosis, although early inflammatory changes affecting soft tissue and bone marrow cannot be detected with its use, or the image is indistinctive. Typical radiographic features of PsA occur in an advanced disease, mainly within the synovial joints, but also in fibrocartilaginous joints, such as sacroiliac joints, and additionally in entheses of tendons and ligaments. Moll and Wright classified PsA into 5 subtypes: asymmetric oligoarthritis, symmetric polyarthritis, arthritis mutilans, distal interphalangeal arthritis of the hands and feet and spinal column involvement. In this part of the paper we discuss radiographic features of the disease. The next one will address magnetic resonance imaging and ultrasonography.

No MeSH data available.


Related in: MedlinePlus

Polyarticular PsA in 32 y.o. female, X-rays, A. DIP joints of the 2–4 fingers of the left hand: bony ankylosis of the DIP joint of the 4th finger; B. the left wrist region: soft tissue swelling, radiocarpal, midcarpal and carpometacarpal joint space narrowing, osteolysis (fluffy apperacance, arrow) of the first metacarpal's base, indistinct outline of the ulnar styloid; C. right forefoot, AP at the top, oblique at the bottom: MTP 5 joint space narrowing, erosions of the medial part of the great toe's proximal phalanx and lateral aspect of the 5th metatarsal's head, osteolysis and erosion in a few interphalangeal joint with concomitant ankylosis of the DIP 2 and 3 joints, degenerative changes in the 1st MCP joint; D. AP of the pelvis: ill-defined articular surface in the anterior part of the right sacroiliac joint with marked subchondral bone osteosclerosis, within the left joint partial and simultaneous widening and narrowing of the joint space (erosions and early ankylosis), image indicative of bilateral sacroiliitis, grade 2 on the right side, grade 3 on the left side
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Figure 0001: Polyarticular PsA in 32 y.o. female, X-rays, A. DIP joints of the 2–4 fingers of the left hand: bony ankylosis of the DIP joint of the 4th finger; B. the left wrist region: soft tissue swelling, radiocarpal, midcarpal and carpometacarpal joint space narrowing, osteolysis (fluffy apperacance, arrow) of the first metacarpal's base, indistinct outline of the ulnar styloid; C. right forefoot, AP at the top, oblique at the bottom: MTP 5 joint space narrowing, erosions of the medial part of the great toe's proximal phalanx and lateral aspect of the 5th metatarsal's head, osteolysis and erosion in a few interphalangeal joint with concomitant ankylosis of the DIP 2 and 3 joints, degenerative changes in the 1st MCP joint; D. AP of the pelvis: ill-defined articular surface in the anterior part of the right sacroiliac joint with marked subchondral bone osteosclerosis, within the left joint partial and simultaneous widening and narrowing of the joint space (erosions and early ankylosis), image indicative of bilateral sacroiliitis, grade 2 on the right side, grade 3 on the left side

Mentions: Early inflammatory changes in PsA affect soft tissue and bone marrow and cannot be detected with the use of plain radiography, or the image is indistinctive (for example soft tissue swelling, increased radiodensity of juxtaarticular soft tissue)(16). With the disease progression this image becomes similar to RA, i.e. joint space narrowing and erosions develop. Characteristic radiographic features of PsA occur in an advanced disease mainly within synovial joints, but also fibrocartilaginous joints, such as sacroiliac joints, and entheses of the tendons and ligaments(8, 10, 16) (Fig. 1).


Diagnostic imaging of psoriatic arthritis. Part I: etiopathogenesis, classifications and radiographic features.

Sudoł-Szopińska I, Matuszewska G, Kwiatkowska B, Pracoń G - J Ultrason (2016)

Polyarticular PsA in 32 y.o. female, X-rays, A. DIP joints of the 2–4 fingers of the left hand: bony ankylosis of the DIP joint of the 4th finger; B. the left wrist region: soft tissue swelling, radiocarpal, midcarpal and carpometacarpal joint space narrowing, osteolysis (fluffy apperacance, arrow) of the first metacarpal's base, indistinct outline of the ulnar styloid; C. right forefoot, AP at the top, oblique at the bottom: MTP 5 joint space narrowing, erosions of the medial part of the great toe's proximal phalanx and lateral aspect of the 5th metatarsal's head, osteolysis and erosion in a few interphalangeal joint with concomitant ankylosis of the DIP 2 and 3 joints, degenerative changes in the 1st MCP joint; D. AP of the pelvis: ill-defined articular surface in the anterior part of the right sacroiliac joint with marked subchondral bone osteosclerosis, within the left joint partial and simultaneous widening and narrowing of the joint space (erosions and early ankylosis), image indicative of bilateral sacroiliitis, grade 2 on the right side, grade 3 on the left side
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834372&req=5

Figure 0001: Polyarticular PsA in 32 y.o. female, X-rays, A. DIP joints of the 2–4 fingers of the left hand: bony ankylosis of the DIP joint of the 4th finger; B. the left wrist region: soft tissue swelling, radiocarpal, midcarpal and carpometacarpal joint space narrowing, osteolysis (fluffy apperacance, arrow) of the first metacarpal's base, indistinct outline of the ulnar styloid; C. right forefoot, AP at the top, oblique at the bottom: MTP 5 joint space narrowing, erosions of the medial part of the great toe's proximal phalanx and lateral aspect of the 5th metatarsal's head, osteolysis and erosion in a few interphalangeal joint with concomitant ankylosis of the DIP 2 and 3 joints, degenerative changes in the 1st MCP joint; D. AP of the pelvis: ill-defined articular surface in the anterior part of the right sacroiliac joint with marked subchondral bone osteosclerosis, within the left joint partial and simultaneous widening and narrowing of the joint space (erosions and early ankylosis), image indicative of bilateral sacroiliitis, grade 2 on the right side, grade 3 on the left side
Mentions: Early inflammatory changes in PsA affect soft tissue and bone marrow and cannot be detected with the use of plain radiography, or the image is indistinctive (for example soft tissue swelling, increased radiodensity of juxtaarticular soft tissue)(16). With the disease progression this image becomes similar to RA, i.e. joint space narrowing and erosions develop. Characteristic radiographic features of PsA occur in an advanced disease mainly within synovial joints, but also fibrocartilaginous joints, such as sacroiliac joints, and entheses of the tendons and ligaments(8, 10, 16) (Fig. 1).

Bottom Line: In this part of the paper we discuss radiographic features of the disease.The next one will address magnetic resonance imaging and ultrasonography.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Radiology Department, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland; Department of Diagnostic Imaging, Second Faculty, Warsaw Medical University, Warsaw, Poland.

ABSTRACT
Psoriatic arthritis is one of the spondyloarthritis. It is a disease of clinical heterogenicity, which may affect peripheral joints, as well as axial spine, with presence of inflammatory lesions in soft tissue, in a form of dactylitis and enthesopathy. Plain radiography remains the basic imaging modality for PsA diagnosis, although early inflammatory changes affecting soft tissue and bone marrow cannot be detected with its use, or the image is indistinctive. Typical radiographic features of PsA occur in an advanced disease, mainly within the synovial joints, but also in fibrocartilaginous joints, such as sacroiliac joints, and additionally in entheses of tendons and ligaments. Moll and Wright classified PsA into 5 subtypes: asymmetric oligoarthritis, symmetric polyarthritis, arthritis mutilans, distal interphalangeal arthritis of the hands and feet and spinal column involvement. In this part of the paper we discuss radiographic features of the disease. The next one will address magnetic resonance imaging and ultrasonography.

No MeSH data available.


Related in: MedlinePlus