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12-01-2016 | Psoriatic arthritis | Book Chapter | Article

19. Radiographic Assessment of Psoriatic Arthritis (PsA)

Authors: MD Javier Rosa, MD, PHD Percival D. Sampaio-Barros, MD, MSC Enrique Roberto Soriano

Publisher: Springer International Publishing


Radiographs are accessible, inexpensive and safe, and therefore remain the generally accepted means for imaging assessment of joint disease in PsA. Radiographs can help in making a diagnosis of PsA, are useful in differentiating PsA from other diseases, and have been used as an outcome measure in the clinical trials and observational studies in PsA. Although there are not specific radiographic features in PsA, there are some typical characteristics that are very useful, and should prompt the physician to think about PsA. These are discussed and described in this chapter, and include: predilection for the distal interphalangeal (DIP) joints of the hands and interphalangeal joint of the great toe, the absence of juxta-articular osteopenia, the presence of large erosions with bony proliferation (pencil-in-cup image), the presence of osteolysis and ankylosis (sometimes in the same hand or finger), periostitis, and the presence of enthesal erosions and calcifications. We also discuss the importance of baseline radiographs in disease prognosis, and the different radiographs scoring methods that have been validated for use in PsA clinical trials and observational studies.

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