Sankowski Artur Jacek, Lebkowska Urszula Maria, Cwikła Jarosław, Walecka Irena, Walecki Jerzy
Department of Radiology, Medical Centre for Postgraduate Education, Warsaw, Poland.
Pol J Radiol. 2013 Jan;78(1):18-29. doi: 10.12659/PJR.883764.
Psoriatic arthritis (PsA) is a chronic inflammatory joint disease which develops in patients with psoriasis. The rheumatoid factor is characteristically absent in the serum of PsA patients. Etiology of the disease is still unclear but a number of genetic associations have been identified. Inheritance of the disease is multilevel and the role of environmental factors is emphasized. Immunology of PsA is also quite complex. Inflammation is caused by immunological reactions leading to a release of kinins. Destructive changes in bones usually appear after a few months from the onset of clinical symptoms.
MATERIAL/METHODS: PsA typically involves joints of the axial skeleton with an asymmetrical patern. The spectrum of symptoms includes inflammatory changes in attachments of articular capsules, tendons, and ligaments to bone surface. The disease can have a diverse clinical course but usually manifests as oligoarthritis.
Imaging plays an important role in the diagnosis of PsA. Classical radiography has been used for this purpose for over a hundred years. It allows to identify late stages of the disease, when bone tissue is affected. In the last 20 years however many new imaging modalities, such as ultrasonography (US), computed tomography (CT) and magnetic resonance (MR), have been developed and became important diagnostic tools for evaluating rheumatoid diseases. They enable the assessment and monitoring of early inflammatory changes.
As a result, patients have earlier access to modern treatment and thus formation of destructive changes in joints can be markedly delayed or even avoided.
银屑病关节炎（PsA）是一种发生于银屑病患者的慢性炎症性关节疾病。银屑病关节炎患者血清中通常不存在类风湿因子。该疾病的病因仍不清楚，但已确定了一些基因关联。疾病的遗传是多层面的，且环境因素的作用也受到重视。银屑病关节炎的免疫学也相当复杂。炎症由免疫反应引起，导致激肽释放。骨骼的破坏性变化通常在临床症状出现数月后出现。
材料/方法：银屑病关节炎通常累及中轴骨骼关节，呈不对称模式。症状谱包括关节囊、肌腱和韧带附着于骨表面处的炎症变化。该疾病的临床病程可能多样，但通常表现为少关节炎。
影像学在银屑病关节炎的诊断中起着重要作用。经典放射学用于此目的已有一百多年历史。它能识别疾病的晚期阶段，即骨组织受影响时。然而在过去20年中，许多新的影像学方法，如超声检查（US）、计算机断层扫描（CT）和磁共振成像（MR）已得到发展，并成为评估类风湿性疾病的重要诊断工具。它们能够评估和监测早期炎症变化。
因此，患者能更早获得现代治疗，从而可显著延迟甚至避免关节破坏性变化的形成。
