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Psoriatic Arthritis
B.J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Diagnostic Checklist

        TERMINOLOGY

        • Abbreviations

          • Psoriatic arthritis (PSA)
        • Synonyms

          • Psoriatic spondyloarthropathy
            • Not true synonym; spine and sacroiliac disease found in subset of patients with PSA
        • Definitions

          • Inflammatory arthritis, usually developing after or coincident with skin changes of psoriasis
            • Arthritis precedes skin change up to 2 years in 15%

        IMAGING

        • General Features

          • Imaging Recommendations

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Lew PP et al: Imaging of disorders affecting the bone and skin. Radiographics. 34(1):197-216, 2014
                                      2. Braum LS et al: Characterisation of hand small joints arthropathy using high-resolution MRI--limited discrimination between osteoarthritis and psoriatic arthritis. Eur Radiol. 23(6):1686-93, 2013
                                      3. Narváez J et al: Can magnetic resonance imaging of the hand and wrist differentiate between rheumatoid arthritis and psoriatic arthritis in the early stages of the disease? Semin Arthritis Rheum. 42(3):234-45, 2012
                                      4. Schwenzer NF et al: The role of dynamic contrast-enhanced MRI in the differential diagnosis of psoriatic and rheumatoid arthritis. AJR Am J Roentgenol. 194(3):715-20, 2010
                                      5. Spira D et al: MRI findings in psoriatic arthritis of the hands. AJR Am J Roentgenol. 195(5):1187-93, 2010
                                      6. Filer CE et al: Investigation of association of genes NAT9, SLC9A3R1 and RAPTOR on chromosome 17q25 with psoriatic arthritis. Ann Rheum Dis. 68(2):292-3, 2009
                                      7. Ly J et al: Axial bone proliferation causing cervical myelopathy in the mutilans form of psoriatic arthritis despite peripheral bone erosion. Ann Rheum Dis. 68(3):443-4, 2009
                                      8. Marzo-Ortega H et al: Magnetic resonance imaging in the assessment of metacarpophalangeal joint disease in early psoriatic and rheumatoid arthritis. Scand J Rheumatol. 38(2):79-83, 2009
                                      9. Wilson FC et al: Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis Rheum. 61(2):233-9, 2009
                                      10. Coates LC et al: Clues to the pathogenesis of psoriasis and psoriatic arthritis from imaging: a literature review. J Rheumatol. 35(7):1438-42, 2008
                                      11. Erdem CZ et al: MR imaging features of foot involvement in patients with psoriasis. Eur J Radiol. 67(3):521-5, 2008
                                      12. Healy PJ et al: MRI changes in psoriatic dactylitis--extent of pathology, relationship to tenderness and correlation with clinical indices. Rheumatology (Oxford). 47(1):92-5, 2008
                                      13. Lee EY et al: MRI findings of juvenile psoriatic arthritis. Skeletal Radiol. 37(11):987-96, 2008
                                      14. McQueen FM et al: MRI in psoriatic arthritis: insights into pathogenesis and treatment response. Curr Rheumatol Rep. 10(4):303-10, 2008
                                      15. Tehranzadeh J et al: Detailed analysis of contrast-enhanced MRI of hands and wrists in patients with psoriatic arthritis. Skeletal Radiol. 37(5):433-42, 2008
                                      16. Weiner SM et al: Ultrasonography in the assessment of peripheral joint involvement in psoriatic arthritis : a comparison with radiography, MRI and scintigraphy. Clin Rheumatol. 27(8):983-9, 2008
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Abbreviations

                                              • Psoriatic arthritis (PSA)
                                            • Synonyms

                                              • Psoriatic spondyloarthropathy
                                                • Not true synonym; spine and sacroiliac disease found in subset of patients with PSA
                                            • Definitions

                                              • Inflammatory arthritis, usually developing after or coincident with skin changes of psoriasis
                                                • Arthritis precedes skin change up to 2 years in 15%

                                            IMAGING

                                            • General Features

                                              • Imaging Recommendations

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • MR Findings

                                                      • Ultrasonographic Findings

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Microscopic Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Lew PP et al: Imaging of disorders affecting the bone and skin. Radiographics. 34(1):197-216, 2014
                                                                          2. Braum LS et al: Characterisation of hand small joints arthropathy using high-resolution MRI--limited discrimination between osteoarthritis and psoriatic arthritis. Eur Radiol. 23(6):1686-93, 2013
                                                                          3. Narváez J et al: Can magnetic resonance imaging of the hand and wrist differentiate between rheumatoid arthritis and psoriatic arthritis in the early stages of the disease? Semin Arthritis Rheum. 42(3):234-45, 2012
                                                                          4. Schwenzer NF et al: The role of dynamic contrast-enhanced MRI in the differential diagnosis of psoriatic and rheumatoid arthritis. AJR Am J Roentgenol. 194(3):715-20, 2010
                                                                          5. Spira D et al: MRI findings in psoriatic arthritis of the hands. AJR Am J Roentgenol. 195(5):1187-93, 2010
                                                                          6. Filer CE et al: Investigation of association of genes NAT9, SLC9A3R1 and RAPTOR on chromosome 17q25 with psoriatic arthritis. Ann Rheum Dis. 68(2):292-3, 2009
                                                                          7. Ly J et al: Axial bone proliferation causing cervical myelopathy in the mutilans form of psoriatic arthritis despite peripheral bone erosion. Ann Rheum Dis. 68(3):443-4, 2009
                                                                          8. Marzo-Ortega H et al: Magnetic resonance imaging in the assessment of metacarpophalangeal joint disease in early psoriatic and rheumatoid arthritis. Scand J Rheumatol. 38(2):79-83, 2009
                                                                          9. Wilson FC et al: Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis Rheum. 61(2):233-9, 2009
                                                                          10. Coates LC et al: Clues to the pathogenesis of psoriasis and psoriatic arthritis from imaging: a literature review. J Rheumatol. 35(7):1438-42, 2008
                                                                          11. Erdem CZ et al: MR imaging features of foot involvement in patients with psoriasis. Eur J Radiol. 67(3):521-5, 2008
                                                                          12. Healy PJ et al: MRI changes in psoriatic dactylitis--extent of pathology, relationship to tenderness and correlation with clinical indices. Rheumatology (Oxford). 47(1):92-5, 2008
                                                                          13. Lee EY et al: MRI findings of juvenile psoriatic arthritis. Skeletal Radiol. 37(11):987-96, 2008
                                                                          14. McQueen FM et al: MRI in psoriatic arthritis: insights into pathogenesis and treatment response. Curr Rheumatol Rep. 10(4):303-10, 2008
                                                                          15. Tehranzadeh J et al: Detailed analysis of contrast-enhanced MRI of hands and wrists in patients with psoriatic arthritis. Skeletal Radiol. 37(5):433-42, 2008
                                                                          16. Weiner SM et al: Ultrasonography in the assessment of peripheral joint involvement in psoriatic arthritis : a comparison with radiography, MRI and scintigraphy. Clin Rheumatol. 27(8):983-9, 2008