Detailed analysis of contrast-enhanced MRI of hands and wrists in patients with psoriatic arthritis

Abstract

Contrast-enhanced MRI unequivocally demonstrated bone marrow edema, erosions, tendon and soft-tissue disease, and median nerve involvement, with good interobserver reliability in patients with PsA of the hands and wrists. Disease was more extensive in the wrists than in the hands.

The Epidemiology of Psoriatic Arthritis

“…43, 94 However, DIP erosions, periosteoal new bone formation, and diffuse soft tissue swelling also may help distinguish RA from PsA. 94 Studies using MRI 95, 96 and ultrasound 97 examined differences among patients with RA and PsA. Findings from these studies have corroborated the differential locations of erosions between RA and PsA and the increased entheseal disease and periosteal involvement in PsA.…”

Onycho-Pachydermatit with extensive bone marrow edema predominant in the metacarpals: a “forme fruste” of POPP?

“…This implies that marrow edema alone without observable periosteal reaction may have a better prognosis implying the efficacy of the treatment. Besides no erosional change has been observed in these bones after the edema as opposed to the proposals of some authors who believe it is a predictor or leading factor in the development of erosions [9,[11][12][13].…”

Imaging in Psoriatic Arthritis

“…37,78,79 Inflammatory and destructive changes do not have PsA-specific features, and can involve any joint. 64 However, MRI findings may be valuable for discriminating between diagnoses.…”