Psoriatic arthritis x ray: Difference between revisions
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==Overview== | ==Overview== | ||
An [[X-rays|x-ray]] may be helpful in the [[diagnosis]] of psoriatic arthritis. Findings on an x-ray suggestive psoriatic arthritis include [[bone]] erosion, characteristic "pencil-in-cup" deformities and proliferative changes. Psoriatic arthritis may also lead to [[periostitis]], [[dactylitis]], or arthritis mutilans. | |||
==[[X-rays|X-ray]] of digits== | |||
* The following changes can be found on an [[X-rays|x-ray]]:<ref name="pmid25231177">{{cite journal |vauthors=McGonagle D, Hermann KG, Tan AL |title=Differentiation between osteoarthritis and psoriatic arthritis: implications for pathogenesis and treatment in the biologic therapy era |journal=Rheumatology (Oxford) |volume=54 |issue=1 |pages=29–38 |date=January 2015 |pmid=25231177 |pmc=4269795 |doi=10.1093/rheumatology/keu328 |url=}}</ref><ref name="pmid16126794">{{cite journal |vauthors=Siannis F, Farewell VT, Cook RJ, Schentag CT, Gladman DD |title=Clinical and radiological damage in psoriatic arthritis |journal=Ann. Rheum. Dis. |volume=65 |issue=4 |pages=478–81 |date=April 2006 |pmid=16126794 |pmc=1798082 |doi=10.1136/ard.2005.039826 |url=}}</ref><ref name="pmid23430715">{{cite journal |vauthors=Haddad A, Chandran V |title=Arthritis mutilans |journal=Curr Rheumatol Rep |volume=15 |issue=4 |pages=321 |year=2013 |pmid=23430715 |doi=10.1007/s11926-013-0321-7 |url=}}</ref> | |||
**Bone destructive changes including formation of subchondral cyst and erosions | |||
** Fluffy [[periostitis]] | |||
** [[Ankylosis]] | |||
** [[Phalanx bones|Phalangeal]] tuft [[acroosteolysis]] | |||
** New [[bone]] formation: Perisoteal and endosteal [[bone]] formation may result in increased [[bone density]] of an entire phalanx resulting in so called ivory phalanx. | |||
** Pencil-in-cup deformity (osteolytic lesions) usually involving [[Interphalangeal articulations of hand|DIP joints]] but also affects [[Interphalangeal articulations of hand|PIP joints]] | |||
** [[Osteolysis]] and [[ankylosis]] both coexists in the same [[Joint|joints]] of [[Hand|hands]] and [[foot]] | |||
** [[Enthesopathy|Enthesitis]] | |||
** [[Dactylitis]] (sausage digit) | |||
** Gross finger [[deformity]] | |||
** [[Arthritis]] mutilans: It may lead to telescoping of fingers caused by marked bony resorption and the subsequent collapse of soft tissue | |||
** Asymmetrical [[sacroiliitis]] | |||
** [[Spondylitis]]: Asymmetric paravertebral ossifications and relative sparing of the facet [[Joint|joints]] | |||
[[File:Psoriatic-arthritis of hands.jpg|centre|thumb|Psoriatic-arthritis of hands showing pencil-in-cup deformity - By Case courtesy of Dr Jeremy Jones, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/8798">rID: 8798</a>]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Arthritis]] | [[Category:Arthritis]] | ||
[[Category:Autoimmune diseases]] | [[Category:Autoimmune diseases]] | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
Latest revision as of 21:16, 14 May 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]
Overview
An x-ray may be helpful in the diagnosis of psoriatic arthritis. Findings on an x-ray suggestive psoriatic arthritis include bone erosion, characteristic "pencil-in-cup" deformities and proliferative changes. Psoriatic arthritis may also lead to periostitis, dactylitis, or arthritis mutilans.
X-ray of digits
- The following changes can be found on an x-ray:[1][2][3]
- Bone destructive changes including formation of subchondral cyst and erosions
- Fluffy periostitis
- Ankylosis
- Phalangeal tuft acroosteolysis
- New bone formation: Perisoteal and endosteal bone formation may result in increased bone density of an entire phalanx resulting in so called ivory phalanx.
- Pencil-in-cup deformity (osteolytic lesions) usually involving DIP joints but also affects PIP joints
- Osteolysis and ankylosis both coexists in the same joints of hands and foot
- Enthesitis
- Dactylitis (sausage digit)
- Gross finger deformity
- Arthritis mutilans: It may lead to telescoping of fingers caused by marked bony resorption and the subsequent collapse of soft tissue
- Asymmetrical sacroiliitis
- Spondylitis: Asymmetric paravertebral ossifications and relative sparing of the facet joints
References
- ↑ McGonagle D, Hermann KG, Tan AL (January 2015). "Differentiation between osteoarthritis and psoriatic arthritis: implications for pathogenesis and treatment in the biologic therapy era". Rheumatology (Oxford). 54 (1): 29–38. doi:10.1093/rheumatology/keu328. PMC 4269795. PMID 25231177.
- ↑ Siannis F, Farewell VT, Cook RJ, Schentag CT, Gladman DD (April 2006). "Clinical and radiological damage in psoriatic arthritis". Ann. Rheum. Dis. 65 (4): 478–81. doi:10.1136/ard.2005.039826. PMC 1798082. PMID 16126794.
- ↑ Haddad A, Chandran V (2013). "Arthritis mutilans". Curr Rheumatol Rep. 15 (4): 321. doi:10.1007/s11926-013-0321-7. PMID 23430715.