Imaging in the diagnosis and management of peripheral psoriatic arthritis

Aydın, Sibel Zehra; Mathew, Ashish Jacob; Koppikar, Sahil; Eder, Lihi; Østergaard, Mikkel

doi:10.1016/j.berh.2020.101594

Cited by 18 publications

(17 citation statements)

References 84 publications

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“…In addition to generating vertical scans in real‐time, OCT devices can also reconstruct scans to produce horizontal sections and three‐dimensional images for better visualization of the blood perfusion within the microcirculatory tissue bed. While OCT findings of structural nail changes predominantly reflect clinical features, this technique can also assess the disease extent in the deeper parts of nail bed, objectively quantify an increase in vessel size or density, and detect a thickened epidermis of the proximal nail fold, previously only seen on histopathology 88 . One practical drawback to OCT is the rather steep learning curve in terms of manoeuvring the device on nails.…”

Section: Discussionmentioning

confidence: 99%

Imaging of the nail unit in psoriatic patients:A systematic scoping review of techniques and terminology

Ortner

Mandel

Bertugno

et al. 2022

Experimental Dermatology

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Background The growing interest in the visualization of psoriatic nail unit changes has led to the discovery of an abundance of image characteristics across various modalities. Objective To identify techniques for non‐invasive imaging of nail unit structures in psoriatic patients and review extracted image features to unify the diverse terminology. Methods For this systematic scoping review, we included studies available on PubMed and Embase, independently extracted image characteristics, and semantically grouped the identified features to suggest a preferred terminology for each technique. Results After screening 753 studies, 67 articles on the visualization of clinical and subclinical psoriatic changes in the nail plate, matrix, bed, folds and hyponychium were included. We identified 4 optical and 3 radiological imaging techniques for the assessment of surface (dermoscopy [n = 16], capillaroscopy [n = 12]), sub‐surface (ultrasound imaging [n = 36], optical coherence tomography [n = 4], fluorescence optical imaging [n = 3]), and deep‐seated psoriatic changes (magnetic resonance imaging [n = 2], positron emission tomography‐computed tomography [n = 1]). By condensing 244 image feature descriptions into a glossary of 82 terms, overall redundancy was cut by 66.4% (37.5%–77.1%). More than 75% of these image features provide additional disease‐relevant information that is not captured using conventional clinical assessment scales. Conclusions This review has identified, unified, and contextualized image features and related terminology for non‐invasive imaging of the nail unit in patients with psoriatic conditions. The suggested glossary could facilitate the integrative use of non‐invasive imaging techniques for the detailed examination of psoriatic nail unit structures in research and clinical practice.

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Section: Discussionmentioning

confidence: 99%

Imaging of the nail unit in psoriatic patients:A systematic scoping review of techniques and terminology

Ortner

Mandel

Bertugno

et al. 2022

Experimental Dermatology

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“…Unlike RA, BMO does not predict the eventual appearance of erosions in PsA [70,72,73]. On MRI, enthesitis is demonstrated by extracapsular BMO at ligamentous and tendinous insertions [70,71,74,75]. From the phalangeal entheseal sites BMO may extend into the diaphyseal region and possibly involve the entire bone [3,9,24,73,75] (Figures 11, 12A, 13A-B).…”

Section: Psoriatic Arthritismentioning

confidence: 99%

“…From the phalangeal entheseal sites BMO may extend into the diaphyseal region and possibly involve the entire bone [3,9,24,73,75] (Figures 11, 12A, 13A-B). Enthesitis in PsA may involve multiple peripheral and axial skeletal sites, and whole-body MRI may be useful in determining the extent of disease [74].…”

Section: Psoriatic Arthritismentioning

confidence: 99%

“…Dactylitis occurs predominantly secondary to flexor tenosynovitis, but it can also result from extratendinous soft tissue thickening, joint effusions, and extensor tendon inflammation [4,24,70,75,[77][78][79]. MRI of dactylitis will show tenosynovitis of the flexor tendon, synovitis of the interphalangeal joints, and occasionally extensor tenosynovitis; enthesitis may also be present [10,23,51,74,[77][78][79] ( Figures 11,12).…”

Section: Psoriatic Arthritismentioning

confidence: 99%

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Magnetic resonance imaging of rheumatological diseases

Weaver¹,

Omar²,

Mar³

et al. 2022

Pol J Radiol

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Magnetic resonance imaging (MRI) is extremely useful in the early diagnosis of rheumatologic diseases, as well as in the monitoring of treatment response and disease progression to optimize long-term clinical outcomes. MRI is highly sensitive and specific in detecting the common findings in rheumatologic diseases, such as bone marrow oedema, cartilage disruption, articular erosions, joint effusions, bursal effusions, tendon sheath effusions, and synovitis. This imaging modality can demonstrate structural changes of cartilage and bone destruction years earlier than radiographs. Rheumatoid arthritis, crystal deposition diseases (including gouty arthropathy and calcium pyrophosphate deposition disease), seronegative spondyloarthropathies (including psoriatic arthritis, reactive arthritis, ankylosing spondylitis), and osteoarthritis have characteristic appearances on MRI. Contrast-enhanced MRI and diffusion-weighted imaging can provide additional evaluation of active synovitis. This article describes the MRI findings of normal joints, as well as the pathophysiological mechanisms and typical MRI findings of rheumatoid arthritis, gouty arthritis, calcium pyrophosphate deposition disease, psoriatic arthritis, reactive arthritis, ankylosing spondylitis, and osteoarthritis.

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“…There are various modalities to screen for early PsA. Among them, ultrasound (US) is a relatively more sensitive and convenient modality for assessing not only the disease activity but also damage of inflammatory arthritis compared with physical examination and other imaging methods [7][8][9][10][11]. More and more studies have noted that US could detect subclinical imaging changes in patients with psoriasis without musculoskeletal symptoms [12][13][14].…”

Section: Introductionmentioning

confidence: 99%