Skip to main content
  • 2478 Accesses

Abstract

Psoriatic arthritis (PsA) is classified as one of the spondyloarthropathies (SpAs), sharing similar characteristics such as involvement of the spine, sacroiliac joints, and enthesis. In addition, PsA commonly leads to a number of characteristic abnormalities either adjacent to or within synovial joints including periostitis, new bone formation, osteolysis, and distinctive changes such as the ‘pencil-in-cup’ deformity. The spectrum of arthritis associated with PsA can lead to disability that is equally severe to that seen in rheumatoid arthritis (RA). From a historic perspective these features were best seen on conventional radiography, especially in well-established PsA, but are often absent in early disease. Nevertheless, these characteristics are useful in differentiating PsA from other forms of inflammatory arthritis, such as RA, as these conditions may often present similarly in the clinical setting.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Barry J, Kirby B. Novel biologic therapies for psoriasis. Expert Opin Biol Ther 2004; 4:975–987.

    Article  PubMed  CAS  Google Scholar 

  2. McGonagle D. Diagnosis and treatment of enthesitis. Rheum Dis Clin North Am 2003; 29:549–560.

    Article  PubMed  Google Scholar 

  3. Taylor WJ, Porter GG, Helliwell PS. Operational definitions and observer reliability of the plain radiographic features of psoriatic arthritis. J Rheumatol 2003; 30:2645–2658.

    PubMed  Google Scholar 

  4. McGonagle D, Conaghan PG, Emery P. Psoriatic arthritis: a unified concept twenty years on. Arthritis Rheum 1999; 42:1080–1086.

    Article  PubMed  CAS  Google Scholar 

  5. Fournie B, Crognier L, Arnaud C et al. Proposed classification criteria of psoriatic arthritis. A preliminary study in 260 patients. Rev Rheum 1999; 66:446–456.

    CAS  Google Scholar 

  6. Tan AL, Wakefield RJ, Conaghan PG et al. Imaging of the musculoskeletal system: magnetic resonance imaging, ultrasonography and computed tomography. Best Pract Res Clin Rheumatol 2003; 17:513–528.

    Article  PubMed  Google Scholar 

  7. Arslan H, Sakarya ME, Adak B et al. Duplex and color Doppler sonographic findings in active sacroiliitis. Am J Roentgenol 1999; 173:677–680.

    CAS  Google Scholar 

  8. Williamson L, Dockerty JL, Dalbeth N et al. Clinical assessment of sacroiliitis and HLA-B27 are poor predictors of sacroiliitis diagnosed by magnetic resonance imaging in psoriatic arthritis. Rheumatology 2004; 43:85–88.

    Article  PubMed  CAS  Google Scholar 

  9. McGonagle D, Marzo-Ortega H, Benjamin M et al. Report on the Second International Enthesitis Workshop. Arthritis Rheum 2003; 48:896–905.

    Article  PubMed  Google Scholar 

  10. Scarpa R, Manguso F, Oriente A et al. Is the involvement of the distal interphalangeal joint in psoriatic patients related to nail psoriasis? Clin Rheumatol 2004; 23:27–30.

    Article  PubMed  Google Scholar 

  11. Williamson L, Dalbeth N, Dockerty JL et al. Extended report: nail disease in psoriatic arthritis — clinically important, potentially treatable and often overlooked. Rheumatology 2004; 43:790–794.

    Article  PubMed  CAS  Google Scholar 

  12. Moll JM, Wright V. Psoriatic arthritis. Semin Arthritis Rheum 1973; 3:55–78.

    Article  PubMed  CAS  Google Scholar 

  13. Forrester DM, Kirkpatrick J. Periostitis and pseudoperiostitis. Radiology 1976; 118:597–601.

    PubMed  CAS  Google Scholar 

  14. Resnick D, Broderick TW. Bony proliferation of terminal toe phalanges in psoriasis: the ‘ivory’ phalanx. J Can Assoc Radiol 1977; 28:187–189.

    PubMed  CAS  Google Scholar 

  15. Martel W, Stuck KJ, Dworin AM et al. Erosive osteoarthritis and psoriatic arthritis: a radiologic comparison in the hand, wrist, and foot. Am J Roentgenol 1980; 134:125–135.

    CAS  Google Scholar 

  16. Marsal S, Armadans-Gil L, Martinez M et al. Clinical, radiographic and HLA associations as markers for different patterns of psoriatic arthritis. Rheumatology 1999; 38:332–337.

    Article  PubMed  CAS  Google Scholar 

  17. Jones SM, Armas JB, Cohen MG et al. Psoriatic arthritis: outcome of disease subsets and relationship of joint disease to nail and skin disease. Br J Rheumatol 1994; 33:834–839.

    Article  PubMed  CAS  Google Scholar 

  18. Helliwell PS, Hickling P, Wright V. Do the radiological changes of classic ankylosing spondylitis differ from the changes found in the spondylitis associated with inflammatory bowel disease, psoriasis, and reactive arthritis? Ann Rheum Dis 1998; 57:135–140.

    Article  PubMed  CAS  Google Scholar 

  19. Laiho K, Kauppi M. The cervical spine in patients with psoriatic arthritis. Ann Rheum Dis 2002; 61:650–652.

    Article  PubMed  CAS  Google Scholar 

  20. McGonagle D, Benjamin M, Marzo-Ortega H et al. Advances in the understanding of entheseal inflammation. Curr Rheumatol Rep 2002; 4:500–506.

    Article  PubMed  Google Scholar 

  21. Dougados M, van der Linden S, Juhlin R et al. The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum 1991; 34:1218–1227.

    Article  PubMed  CAS  Google Scholar 

  22. Balint PV, Kane D, Wilson H et al. Ultrasonography of entheseal insertions in the lower limb in spondyloarthropathy. Ann Rheum Dis 2002; 61:905–910.

    Article  PubMed  CAS  Google Scholar 

  23. D’Agostino MA, Said-Nahal R, Hacquard-Bouder C et al. Assessment of peripheral enthesitis in the spondylarthropathies by ultrasonography combined with power Doppler: a cross-sectional study. Arthritis Rheum 2003; 48:523–533.

    Article  PubMed  Google Scholar 

  24. McGonagle D, Khan MA, Marzo-Ortega H et al. Enthesitis in spondyloarthropathy. Curr Opin Rheumatol 1999; 11:244–250.

    Article  PubMed  CAS  Google Scholar 

  25. Lehtinen A, Taavitsainen M, Leirisalo-Repo M. Sonographic analysis of enthesopathy in the lower extremities of patients with spondylarthropathy. Clin Exp Rheumatol 1994; 12:143–148.

    PubMed  CAS  Google Scholar 

  26. Scarpa R. Peripheral enthesopathies in psoriatic arthritis. J Rheumatol 1998; 25:2288–2289.

    PubMed  CAS  Google Scholar 

  27. D’Agostino MA, Breban M, Said-Nahal R et al. Refractory inflammatory heel pain in spondylarthropathy: a significant response to infliximab documented by ultrasound. Arthritis Rheum 2002; 46:840–841. Author reply 841–843.

    Article  PubMed  Google Scholar 

  28. Antoni C, Dechant C, Hanns-Martin Lorenz PD et al. Open-label study of infliximab treatment for psoriatic arthritis: clinical and magnetic resonance imaging measurements of reduction of inflammation. Arthritis Rheum 2002; 47:506–512.

    Article  PubMed  CAS  Google Scholar 

  29. Tan AL, Grainger AJ, Tanner SF et al. A high-resolution magnetic resonance imaging study of distal interphalangeal joint arthropathy in psoriatic arthritis and osteoarthritis: are they the same? Arthritis Rheum 2006; 54:1328–1333.

    Article  PubMed  Google Scholar 

  30. Reece RJ, Kraan MC, Radjenovic A et al. Comparative assessment of leflunomide and methotrexate for the treatment of rheumatoid arthritis, by dynamic enhanced magnetic resonance imaging. Arthritis Rheum 2002; 46:366–372.

    Article  PubMed  CAS  Google Scholar 

  31. Rhodes LA, Tan AL, Tanner SF et al. Regional variation and differential response to therapy of knee synovitis adjacent to the cartilage pannus junction and suprapatellar pouch in inflammatory arthritis: Implications for pathogenesis and therapy of inflammatory arthritis. Arthritis Rheum 2004; 50:2428–2432.

    Article  PubMed  Google Scholar 

  32. Earwaker JW, Cotten A. SAPHO: syndrome or concept? Imaging findings. Skeletal Radiol 2003; 32:311–327.

    PubMed  CAS  Google Scholar 

  33. Marchesoni A, Helliwell P, Gallazzi M et al. Psoriatic arthritis in British and Italian patients: a comparative clinical, radiologic, and scintigraphic study. J Rheumatol 1999; 26:2619–2621.

    PubMed  CAS  Google Scholar 

  34. Hayem G, Bouchaud-Chabot A, Benali K et al. SAPHO syndrome: a long-term follow-up study of 120 cases. Semin Arthritis Rheum 1999; 29:159–171.

    Article  PubMed  CAS  Google Scholar 

  35. Salonen DC, Brower AC et al. Seronegative spondyloarthropathies: imaging. In: Rheumatology. Edited by MC Hochberg, AJ Silman, JS Smolen. Philadelphia: Mosby, 2003; 1193–1204.

    Google Scholar 

  36. Battistone MJ, Manaster BJ, Reda DJ et al. The prevalence of sacroilitis in psoriatic arthritis: new perspectives from a large, multicenter cohort. A Department of Veterans Affairs Cooperative Study. Skeletal Radiol 1999; 28:196–201.

    Article  PubMed  CAS  Google Scholar 

  37. Puhakka KB, Jurik AG, Schiottz-Christensen B et al. Magnetic resonance imaging of sacroiliitis in early seronegative spondylarthropathy. Abnormalities correlated to clinical and laboratory findings. Rheumatology 2004; 43:234–237.

    Article  PubMed  CAS  Google Scholar 

  38. Queiro R, Sarasqueta C, Belzunegui J et al. Psoriatic spondyloarthropathy: a comparative study between HLA-B27 positive and HLA-B27 negative disease. Semin Arthritis Rheum 2002; 31:413–418.

    Article  PubMed  Google Scholar 

  39. Tsai YG, Chang DM, Kuo SY et al. Relationship between human lymphocyte antigen-B27 and clinical features of psoriatic arthritis. J Microbiol Immunol Infect 2003; 36:101–104.

    PubMed  Google Scholar 

  40. Braun J, Sieper J. The sacroiliac joint in the spondyloarthropathies. Curr Opin Rheumatol 1996; 8:275–287.

    Article  PubMed  CAS  Google Scholar 

  41. Bollow M, Fischer T, Reisshauer H et al. Quantitative analyses of sacroiliac biopsies in spondyloarthropathies: T cells and macrophages predominate in early and active sacroiliitis — cellularity correlates with the degree of enhancement detected by magnetic resonance imaging. Ann Rheum Dis 2000; 59:135–140.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer-Verlag London Limited

About this chapter

Cite this chapter

Tan, A.L., McGonagle, D. (2008). Imaging. In: Mease, P.J., Helliwell, P.S. (eds) Atlas of Psoriatic Arthritis. Springer, London. https://doi.org/10.1007/978-1-84628-897-5_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-84628-897-5_4

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-896-8

  • Online ISBN: 978-1-84628-897-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics