Early musculoskeletal MRI findings in a cohort of patients with psoriasis in central Greece

Dimitra Alifakioti, Efterpi Zafiriou, Angeliki Roussaki-Schulze, Aikaterini Vassiou, Paschal Thriskos, Marianna Vlychou


Purpose: The purpose of the presence cohort study is to investigate the extent of early articular involvement of peripheral skeleton determined by MRI in patients with psoriasis.

Materials and methods: Seventy five (75) eligible patients with psoriasis and nail involvement were assessed according to NAPSI, PASI score and underwent a 3 Tesla MRI study of either hand or foot, depending on the most affected area.

Results: Based on our findings, bone oedema was found in 41% of our patients (31 patients), cysts were found in 9% corresponding to seven patients. Both bone radiological findings were recorded to 7% corresponding to five patients. In soft tissue imaging findings we included mostly the sausage digit and six patients were recorded with this abnormal finding. In the last radiological finding category concerned the joints, erosions were recorded in 26 patients (35%), synovitis in 49 (65%), enthesitis in 44 patients (59%), tendonitis in 36 patients corresponding to 48% of total patients and all the above simultaneously in 15 patients corresponding to 20% of all patients. All patients with positive inflammatory findings were suffering from nail psoriasis and were associated with a high NAPSI score. A statistically significant correlation was found between group 4 with NAPSI score 120-160 and overall imaging findings of either hand (p – 0.03) or foot (p=0.04).

Conclusion: MRI is a useful tool with an important diagnostic role in the detection of early psoriatic arthritis (PsA) of the peripheral skeleton, in a selected group of patients with extensive cutaneous involvement and nail psoriasis. Collaboration between radiologists and dermatologists could prevent the development of psoriasis into PsA and irreversible joint disease.


psoriasis, psoriatic arthritis, nail psoriasis, MRI

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Eder, L., et al., The Incidence and Risk Factors for Psoriatic Arthritis in Patients With Psoriasis: A Prospective Cohort Study. Arthritis Rheumatol, 2016. 68(4): p. 915-23.

Gottlieb, A.B. and J.F. Merola, Axial psoriatic arthritis: An update for dermatologists. J Am Acad Dermatol, 2021. 84(1): p. 92-101.

McGonagle, D., Enthesitis: an autoinflammatory lesion linking nail and joint involvement in psoriatic disease. J Eur Acad Dermatol Venereol, 2009. 23 Suppl 1: p. 9-13.

Wilson, F.C., et al., Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis Rheum, 2009. 61(2): p. 233-9.

Belinchon, I., et al., Dermatologists’ Role in the Early Diagnosis of Psoriatic Arthritis: Expert Recommendations. Actas Dermosifiliogr (Engl Ed), 2020. 111(10): p. 835-846.

Kaeley, G.S., et al., Nail Psoriasis: Diagnosis, Assessment, Treatment Options, and Unmet Clinical Needs. J Rheumatol, 2021. 48(8): p. 1208-1220.

Gottlieb, A. and J.F. Merola, Psoriatic arthritis for dermatologists. J Dermatolog Treat, 2020. 31(7): p. 662-679.

Faustini, F., et al., Subclinical joint inflammation in patients with psoriasis without concomitant psoriatic arthritis: a cross-sectional and longitudinal analysis. Ann Rheum Dis, 2016. 75(12): p. 2068-2074.

Erdem, C.Z., et al., MR imaging features of foot involvement in patients with psoriasis. Eur J Radiol, 2008. 67(3): p. 521-5.

Egeberg, A., et al., Incidence and prevalence of psoriatic arthritis in Denmark: a nationwide register linkage study. Ann Rheum Dis, 2017. 76(9): p. 1591-1597.

Hayashi, M., et al., Superiority of magnetic resonance imaging over conventional radiography in the early diagnosis of psoriatic arthritis. J Dermatol, 2017. 44(10): p. e232-e233.

Spira, D., et al., MRI findings in psoriatic arthritis of the hands. AJR Am J Roentgenol, 2010. 195(5): p. 1187-93.

Scarpa, R., et al., Nail and distal interphalangeal joint in psoriatic arthritis. J Rheumatol, 2006. 33(7): p. 1315-9.

Langenbruch, A., et al., Nail involvement as a predictor of concomitant psoriatic arthritis in patients with psoriasis. Br J Dermatol, 2014. 171(5): p. 1123-8.

Raposo, I. and T. Torres, Nail psoriasis as a predictor of the development of psoriatic arthritis. Actas Dermosifiliogr, 2015. 106(6): p. 452-7.

Pennington, S.R. and O. FitzGerald, Early Origins of Psoriatic Arthritis: Clinical, Genetic and Molecular Biomarkers of Progression From Psoriasis to Psoriatic Arthritis. Front Med (Lausanne), 2021. 8: p. 723944.

Ventura, A., et al., New insight into the pathogenesis of nail psoriasis and overview of treatment strategies. Drug Des Devel Ther, 2017. 11: p. 2527-2535.

Ash, Z.R., et al., Psoriasis patients with nail disease have a greater magnitude of underlying systemic subclinical enthesopathy than those with normal nails. Ann Rheum Dis, 2012. 71(4): p. 553-6.

Mathew, A.J., et al., Psoriatic arthritis: lessons from imaging studies and implications for therapy. Expert Rev Clin Immunol, 2017. 13(2): p. 133-142.

Coates, L.C. and P.S. Helliwell, Psoriatic arthritis: state of the art review. Clin Med (Lond), 2017. 17(1): p. 65-70.

DOI: http://dx.doi.org/10.36162/hjr.v7i2.497


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