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Magnetic Resonance Imaging in Psoriatic Arthritis

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Psoriatic Arthritis and Psoriasis

Abstract

Psoriatic arthritis (PsA) is an inflammatory joint disease characterised by presence of arthritis and often enthesitis in patients with psoriasis, but presenting a wide range of disease manifestations in various patterns. Imaging is an integral part of management of PsA, and is used for multiple reasons including establishing or confirming a diagnosis of inflammatory joint disease, determining the extent of disease, monitoring activity and damage, assessing therapeutic efficacy, and identifying complications of disease or treatment, in the setting of clinical practice or clinical studies. Magnetic resonance imaging (MRI) allows assessment of all peripheral and axial joints involved in PsA, and can visualise both inflammation and structural changes. In this paper, we will provide an overview of the status, strengths and limitations of MRI in PsA, in routine clinical practice and clinical trials.

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References

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

    Article  PubMed  CAS  Google Scholar 

  2. Moll JM. Psoriatic arthritis. Br J Rheumatol. 1984;23:241–4.

    Article  PubMed  CAS  Google Scholar 

  3. Moll JM, Wright V. Familial occurrence of psoriatic arthritis. Ann Rheum Dis. 1973;32:181–201.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Moll JM, Haslock I, Macrae IF, et al. Associations between ankylosing spondylitis, psoriatic arthritis, Reiter's disease, the intestinal arthropathies, and Behcet's syndrome. Medicine (Baltimore). 1974;53:343–64.

    Article  CAS  Google Scholar 

  5. McQueen F, Lassere M, Ostergaard M. Magnetic resonance imaging in psoriatic arthritis: a review of the literature. Arthritis Res Ther. 2006;8:207.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Østergaard M, McQueen F, Wiell C, et al. The OMERACT psoriatic arthritis magnetic resonance imaging scoring system (PsAMRIS): definitions of key pathologies, suggested MRI sequences, and preliminary scoring system for PsA Hands. J Rheumatol. 2009;36:1816–24.

    Article  PubMed  Google Scholar 

  7. Tan AL, McGonagle D. Imaging of seronegative spondyloarthritis. Best Pract Res Clin Rheumatol. 2008;22:1045–59.

    Article  PubMed  CAS  Google Scholar 

  8. Sieper J, Rudwaleit M, Baraliakos X, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis. 2009;68 Suppl 2:ii1–44.

    Article  PubMed  Google Scholar 

  9. Rudwaleit M, van der Heijde D, Landewe R, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68:777–83.

    Article  PubMed  CAS  Google Scholar 

  10. Rudwaleit M, Jurik AG, Hermann KG, et al. Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group. Ann Rheum Dis. 2009;68:1520–7.

    Article  PubMed  CAS  Google Scholar 

  11. Eshed I, Bollow M, McGonagle DG, et al. MRI of enthesitis of the appendicular skeleton in spondyloarthritis. Ann Rheum Dis. 2007;66:1553–9.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Althoff CE, Sieper J, Song IH, et al. Active inflammation and structural change in early active axial spondyloarthritis as detected by whole-body MRI. Ann Rheum Dis. 2013;72:967–73.

    Article  PubMed  Google Scholar 

  13. Ostergaard M, Maksymowych W, Pedersen SJ, et al. Structural lesions detected by magnetic resonance imaging in the spine of patients with spondyloarthritis – definitions, assessment system, and reference image set. J Rheumatol. 2009;36 Suppl 84:18–34.

    Google Scholar 

  14. Ghanem N, Uhl M, Pache G, et al. MRI in psoriatic arthritis with hand and foot involvement. Rheumatol Int. 2007;27:387–93.

    Article  PubMed  Google Scholar 

  15. Wiell C, Szkudlarek M, Hasselquist M, et al. Ultrasonography, magnetic resonance imaging, radiography, and clinical assessment of inflammatory and destructive changes in fingers and toes of patients with psoriatic arthritis. Arthritis Res Ther. 2007;9:R119.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Tehranzadeh J, Ashikyan O, Anavim A, et al. Detailed analysis of contrast-enhanced MRI of hands and wrists in patients with psoriatic arthritis. Skeletal Radiol. 2008;37:433–42.

    Article  PubMed  Google Scholar 

  17. Schoellnast H, Deutschmann HA, Hermann J, et al. Psoriatic arthritis and rheumatoid arthritis: findings in contrast-enhanced MRI. AJR Am J Roentgenol. 2006;187:351–7.

    Article  PubMed  Google Scholar 

  18. Narvaez J, Narvaez JA, de Albert M, 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. 2012;42:234–45.

    Article  PubMed  Google Scholar 

  19. Totterman SM. Magnetic resonance imaging of psoriatic arthritis: insight from traditional and three-dimensional analysis. Curr Rheumatol Rep. 2004;6:317–21.

    Article  PubMed  Google Scholar 

  20. Braum LS, McGonagle D, Bruns A, et al. Characterisation of hand small joints arthropathy using high-resolution MRI – limited discrimination between osteoarthritis and psoriatic arthritis. Eur Radiol. 2013;23:1686–93.

    Article  PubMed  Google Scholar 

  21. Offidani A, Cellini A, Valeri G, et al. Subclinical joint involvement in psoriasis: magnetic resonance imaging and X-ray findings. Acta Derm Venereol. 1998;78:463–5.

    Article  PubMed  CAS  Google Scholar 

  22. Erdem CZ, Tekin NS, Sarikaya S, et al. MR imaging features of foot involvement in patients with psoriasis. Eur J Radiol. 2008;67:521–5.

    Article  PubMed  Google Scholar 

  23. Emad Y, Ragab Y, Bassyouni I, et al. Enthesitis and related changes in the knees in seronegative spondyloarthropathies and skin psoriasis: magnetic resonance imaging case–control study. J Rheumatol. 2010;37:1709–17.

    Article  PubMed  Google Scholar 

  24. Tan YM, Østergaard M, Doyle A, et al. MRI bone oedema scores are higher in the arthritis mutilans form of psoriatic arthritis and correlate with high radiographic scores for joint damage. Arthritis Res Ther. 2009;11:R2.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Poggenborg RP, Wiell C, Boyesen P, et al. No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients: results from an investigator-initiated 48-week comparative magnetic resonance imaging, computed tomography and radiography trial. Rheumatology (Oxford). 2014;53:746–56.

    Article  CAS  Google Scholar 

  26. Queiro R, Tejon P, Alonso S, et al. Erosive discovertebral lesion (Andersson lesion) as the first sign of disease in axial psoriatic arthritis. Scand J Rheumatol. 2013;42:220–5.

    Article  PubMed  CAS  Google Scholar 

  27. Bochkova AG, Levshakova AV, Bunchuk NV, et al. Spinal inflammation lesions as detected by magnetic resonance imaging in patients with early ankylosing spondylitis are more often observed in posterior structures of the spine. Rheumatology (Oxford). 2010;49:749–55.

    Article  Google Scholar 

  28. Lambert RG, Pedersen SJ, Maksymowych W, et al. Active inflammatory lesions detected by magnetic resonance imaging in the spine of patients with spondyloarthritis – definitions, assessment system and reference image set. J Rheumatol. 2009;36 Suppl 84:3–17.

    Google Scholar 

  29. Poggenborg RP, Eshed I, Pedersen SJ, et al. Whole-body MRI for assessment of enthesitis in psoriatic arthritis, axial spondyloarthritis and healthy subjects – a comparison with 7 clinical enthesitis indices [abstract]. Ann Rheum Dis. 2012;71 Suppl 3:110.

    Article  Google Scholar 

  30. 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;57:135–40.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  31. 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 (Oxford). 2004;43:85–8.

    Article  CAS  Google Scholar 

  32. Østergaard M, Poggenborg RP, Axelsen MB, et al. Magnetic resonance imaging in spondyloarthritis--how to quantify findings and measure response. Best Pract Res Clin Rheumatol. 2010;24:637–57.

    Article  PubMed  Google Scholar 

  33. 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;59:135–40.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  34. Castillo-Gallego C, Aydin SZ, Emery P, et al. Magnetic resonance imaging assessment of axial psoriatic arthritis: extent of disease relates to HLA-B27. Arthritis Rheum. 2013;65:2274–8.

    Article  PubMed  Google Scholar 

  35. Gossec L, Smolen JS, Gaujoux-Viala C, et al. European league against rheumatism recommendations for the management of psoriatic arthritis with pharmacological therapies. Ann Rheum Dis. 2012;71:4–12.

    Article  PubMed  CAS  Google Scholar 

  36. Weckbach S. Whole-body MRI, for inflammatory arthritis and other multifocal rheumatoid diseases. Semin Musculoskelet Radiol. 2012;16:377–88.

    Article  PubMed  Google Scholar 

  37. Weckbach S, Schewe S, Michaely HJ, et al. Whole-body MR imaging in psoriatic arthritis: additional value for therapeutic decision making. Eur J Radiol. 2011;77:149–55.

    Article  PubMed  Google Scholar 

  38. Poggenborg RP, Eshed I, Ostergaard M, et al. Enthesitis in patients with psoriatic arthritis, axial spondyloarthritis and healthy subjects assessed by ‘head-to-toe’ whole-body MRI and clinical examination. Ann Rheum Dis. 2014;74(5):823–9. doi:10.1136/annrheumdis-2013-204239.

    Article  PubMed  Google Scholar 

  39. Poggenborg RP, Pedersen SJ, Eshed I, et al. Head-to-toe whole-body MRI in psoriatic arthritis, axial spondyloarthritis and healthy subjects: first steps towards global inflammation and damage scores of peripheral and axial joints. Rheumatology (Oxford). 2014;54(6):1039–49.

    Google Scholar 

  40. Cimmino MA, Parodi M, Innocenti S, et al. Dynamic magnetic resonance of the wrist in psoriatic arthritis reveals imaging patterns similar to those of rheumatoid arthritis. Arthritis Res Ther. 2005;7:R725–31.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Marzo-Ortega H, Tanner SF, Rhodes LA, et al. Magnetic resonance imaging in the assessment of metacarpophalangeal joint disease in early psoriatic and rheumatoid arthritis. Scand J Rheumatol. 2009;38:79–83.

    Article  PubMed  CAS  Google Scholar 

  42. Schraml C, Schwenzer NF, Martirosian P, et al. Assessment of synovitis in erosive osteoarthritis of the hand using DCE-MRI and comparison with that in its major mimic, the psoriatic arthritis. Acad Radiol. 2011;18:804–9.

    Article  PubMed  Google Scholar 

  43. Schwenzer NF, Kotter I, Henes JC, et al. The role of dynamic contrast-enhanced MRI in the differential diagnosis of psoriatic and rheumatoid arthritis. AJR Am J Roentgenol. 2010;194:715–20.

    Article  PubMed  Google Scholar 

  44. Strube H, Becker-Gaab C, Saam T, et al. Feasibility and reproducibility of the PsAMRIS-H score for psoriatic arthritis in low-field-strength dedicated extremity magnetic resonance imaging. Scand J Rheumatol. 2013;42:379–82.

    Article  PubMed  CAS  Google Scholar 

  45. Cimmino MA, Barbieri F, Boesen M, et al. Dynamic contrast-enhanced magnetic resonance imaging of articular and extraarticular synovial structures of the hands in patients with psoriatic arthritis. J Rheumatol Suppl. 2012;89:44–8.

    Article  PubMed  Google Scholar 

  46. 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;47:506–12.

    Article  PubMed  CAS  Google Scholar 

  47. Anandarajah AP, Ory P, Salonen D, et al. Effect of adalimumab on joint disease: features of patients with psoriatic arthritis detected by magnetic resonance imaging. Ann Rheum Dis. 2010;69:206–9.

    Article  PubMed  CAS  Google Scholar 

  48. Boyesen P, McQueen FM, Gandjbakhch F, et al. The OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) is reliable and sensitive to change: results from an OMERACT workshop. J Rheumatol. 2011;38:2034–8.

    Article  PubMed  Google Scholar 

  49. McQueen F, Lassere M, Bird P, et al. Developing a magnetic resonance imaging scoring system for peripheral psoriatic arthritis. J Rheumatol. 2007;34:859–61.

    PubMed  Google Scholar 

  50. McQueen F, Lloyd R, Doyle A, et al. Zoledronic acid does not reduce MRI erosive progression in PsA but may suppress bone oedema: the Zoledronic Acid in Psoriatic Arthritis (ZAPA) Study. Ann Rheum Dis. 2011;70:1091–4.

    Article  PubMed  CAS  Google Scholar 

  51. Mease P, Genovese MC, Gladstein G, et al. Abatacept in the treatment of patients with psoriatic arthritis: results of a six-month, multicenter, randomized, double-blind, placebo-controlled, phase II trial. Arthritis Rheum. 2011;63:939–48.

    Article  PubMed  CAS  Google Scholar 

  52. Østergaard M, Glinatsi D, Pedersen SJ, et al. Utility in Clinical Trials of Magnetic Resonance Imaging for Psoriatic Arthritis: A Report from the GRAPPA 2014 Annual Meeting. J Rheumatol June 2015 42(6):1044–1047.

    Google Scholar 

  53. Hermann KG, Braun J, Fischer T, et al. Magnetic resonance tomography of sacroiliitis: anatomy, histological pathology, MR-morphology, and grading. Radiologe. 2004;44:217–28.

    Article  PubMed  CAS  Google Scholar 

  54. Maksymowych WP, Inman RD, Salonen D, et al. Spondyloarthritis research consortium of Canada magnetic resonance imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis. Arthritis Rheum. 2005;53:703–9.

    Article  PubMed  Google Scholar 

  55. Maksymowych WP, Wichuk S, Chiowchanwisawakit P, et al. Fat metaplasia and backfill are key intermediaries in the development of sacroiliac joint ankylosis in patients with ankylosing spondylitis. Arthritis Rheumatol. 2014;66:2958–67.

    Article  PubMed  Google Scholar 

  56. Maksymowych WP, Wichuk S, Chiowchanwisawakit P, et al. Development and preliminary validation of the spondyloarthritis research consortium of Canada magnetic resonance imaging sacroiliac joint structural score. J Rheumatol. 2015;42:79–86.

    Article  PubMed  Google Scholar 

  57. Haibel H, Rudwaleit M, Brandt HC, et al. Adalimumab reduces spinal symptoms in active ankylosing spondylitis: clinical and magnetic resonance imaging results of a fifty-two-week open-label trial. Arthritis Rheum. 2006;54:678–81.

    Article  PubMed  CAS  Google Scholar 

  58. Maksymowych WP, Inman RD, Salonen D, et al. Spondyloarthritis research consortium of Canada magnetic resonance imaging index for assessment of spinal inflammation in ankylosing spondylitis. Arthritis Rheum. 2005;53:502–9.

    Article  PubMed  Google Scholar 

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Correspondence to René Panduro Poggenborg MD, PhD .

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Poggenborg, R.P., Glinatsi, D., Østergaard, M. (2016). Magnetic Resonance Imaging in Psoriatic Arthritis. 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_21

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  • DOI: https://doi.org/10.1007/978-3-319-19530-8_21

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