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Radiographic Assessment of Psoriatic Arthritis (PsA)

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Psoriatic Arthritis and Psoriasis

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Abstract

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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Author information

Authors and Affiliations

  1. Department of Rheumatology, Instituto Universitario Hospital Italiano de Buenos Aires, Peron 4190 (1181). CABA, Buenos Aires, Argentina

    Javier Rosa MD & Enrique Roberto Soriano MD, MSC

  2. Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    Percival D. Sampaio-Barros MD, PHD

Authors
  1. Javier Rosa MD
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  2. Percival D. Sampaio-Barros MD, PHD
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  3. Enrique Roberto Soriano MD, MSC
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Corresponding author

Correspondence to Enrique Roberto Soriano MD, MSC .

Editor information

Editors and Affiliations

  1. Faculty of Medicine, University of Sheffield, Sheffield, United Kingdom

    Adewale Adebajo

  2. Faculty of Medicine, University of Geneva, Geneva 14, Switzerland

    Wolf-Henning Boehncke

  3. Toronto Western Hospital, Toronto, Ontario, Canada

    Dafna D. Gladman

  4. Seattle Rheumatology Associates, Seattle, Washington, USA

    Philip J. Mease

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Rosa, J., Sampaio-Barros, P.D., Soriano, E.R. (2016). Radiographic Assessment of Psoriatic Arthritis (PsA). In: Adebajo, A., Boehncke, WH., Gladman, D., Mease, P. (eds) Psoriatic Arthritis and Psoriasis. Springer, Cham. https://doi.org/10.1007/978-3-319-19530-8_19

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  • DOI: https://doi.org/10.1007/978-3-319-19530-8_19

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