Department of Internal Medicine 3 and Institute for Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany.
Ann Rheum Dis. 2011 Jan;70(1):122-7. doi: 10.1136/ard.2010.132423. Epub 2010 Oct 11.
Psoriatic arthritis (PsA) and rheumatoid arthritis (RA) are both destructive arthritides but may differ substantially in their periarticular bone changes.
To investigate the differences in the structural changes of periarticular bone in patients with PsA and RA by a high-resolution imaging technique designed to visualise the bone architecture.
30 patients with PsA and 58 patients with RA received a µCT scan to compare structural bone changes in the metacarpophalangeal joints of the dominantly affected hand. Number, extent, form and distribution of bone erosions, osteophytes and cortical thinning were recorded. In addition, the size and depth of bone erosions and the size of osteophytes were determined.
Patients with PsA and RA had the same number of bone erosions, but they were less severe and overall smaller in size and depth in PsA. Erosions in PsA were mostly Ω-shaped and tubule-shaped, whereas U-shaped lesions were most typical for RA. Erosions in PsA were more evenly distributed, lacking the strong preponderance for the radial sites found in RA. Osteophytes were increased in number, extent and size in PsA as compared with RA, often affecting the entire circumference of bone ('bony corona').
High-resolution µCT imaging shows profound differences in periarticular bone changes between PsA and RA. Smaller Ω-shaped and tubule-shaped bone erosions as well as large sometimes corona-shaped osteophytes are typical for PsA. These data suggest that mechanisms of bone repair may be more active in PsA than in RA.
银屑病关节炎（PsA）和类风湿关节炎（RA）都是破坏性关节炎，但它们的关节周围骨改变可能有很大的不同。
通过一种旨在可视化骨结构的高分辨率成像技术，研究 PsA 和 RA 患者关节周围骨结构变化的差异。
30 例 PsA 患者和 58 例 RA 患者接受了 µCT 扫描，以比较优势手掌指关节的结构骨变化。记录骨侵蚀、骨赘和皮质变薄的数量、程度、形态和分布。此外，还确定了骨侵蚀的大小和深度以及骨赘的大小。
PsA 和 RA 患者的骨侵蚀数量相同，但 PsA 中的骨侵蚀程度较轻，总体上较小且深度较浅。PsA 中的侵蚀大多呈 Ω 形和管状，而 U 形病变是 RA 的典型特征。PsA 中的侵蚀分布更均匀，缺乏 RA 中桡侧部位的强烈优势。与 RA 相比，PsA 中的骨赘数量、程度和大小均增加，常累及整个骨周（“骨冠状”）。
高分辨率 µCT 成像显示 PsA 和 RA 之间关节周围骨改变存在明显差异。较小的 Ω 形和管状骨侵蚀以及较大的有时呈冠状的骨赘是 PsA 的典型特征。这些数据表明，PsA 中的骨修复机制可能比 RA 更活跃。
