Bollow Matthias
Ruhr-Universität Bochum, Bochum, Deutschland.
Klinik für diagnostische und interventionelle Radiologie, Augusta-Kranken-Anstalt Bochum, Bergstraße 26, 44791, Bochum, Deutschland.
Radiologe. 2021 May;61(5):448-457. doi: 10.1007/s00117-021-00841-3. Epub 2021 Mar 30.
Psoriatic arthritis (PsA) is considered the prototype of peripheral spondyloarthritides (SpA) and is associated as skin-bone disease (SkiBo) with typical skin changes and with typical arthritides of the joints, especially of the hands and feet.
Systematic review of imaging manual findings patterns in PsA with its typical enthesitic arthritides in context with clinical findings.
A review based on the current literature on the subject from a radiological and rheumatological point of view is provided.
In PsA, inflammatory manifestations in the hands and feet are the most frequently affected regions of the body. Image morphological variability between early and late stages is evident. The projection radiographic characteristic of PsA is the simultaneous coexistence of osteodestructive-rarefactive changes with typical osteoproliferative-proliferative changes, which are part of the Classification of Psoriatic Arthritis (CASPAR) criteria. With the help of magnetic resonance imaging (MRI), the image-morphological spondyloarthritis inflammatory patterns of enthesitis, dactylitis and osteitis can be detected in the hands even in the early stages.
The basic knowledge of the image morphological changes of this complex autoimmunological skin-bone disease will be imparted in order to gain the necessary confidence in the systematic diagnostic evaluation of hand arthritis patterns typical for PsA in images both at the initial diagnosis and over the course of the disease and in the classification of early and late stages, which serve as a guide for rheumatologists regarding "step-up" treatments.
银屑病关节炎(PsA)被认为是外周型脊柱关节炎(SpA)的典型代表,是一种皮肤-骨骼疾病(SkiBo),伴有典型的皮肤改变以及关节尤其是手和足的典型关节炎。
结合临床发现,对PsA典型附着点炎的影像学手工检查结果模式进行系统综述。
从放射学和风湿病学角度,基于该主题的当前文献进行综述。
在PsA中,手和足的炎症表现是身体最常受累的部位。早期和晚期之间的影像形态学差异明显。PsA的投影放射学特征是骨破坏-稀疏性改变与典型的骨增殖-增生性改变同时并存,这是银屑病关节炎分类标准(CASPAR)的一部分。借助磁共振成像(MRI),即使在早期阶段,也能在手中检测到附着点炎、指(趾)炎和骨炎的影像形态学脊柱关节炎炎症模式。
将传授这种复杂自身免疫性皮肤-骨骼疾病影像形态学变化的基础知识,以便在初始诊断时以及疾病过程中,对PsA典型的手部关节炎模式在影像上进行系统诊断评估时,以及在早期和晚期分类中获得必要的信心,这可为风湿病学家进行“强化”治疗提供指导。