M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, and Department of Clinical Medicine, Faculty for Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;
S. Møller-Bisgaard, MD, PhD, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, and Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark.
J Rheumatol. 2024 Oct 1;51(Suppl 2):25-30. doi: 10.3899/jrheum.2024-0291.
Proper assessment of patients with psoriatic arthritis (PsA) requires assessment of all disease domains, including axial disease. Magnetic resonance imaging (MRI) is the method of choice for evaluating axial involvement in PsA. When assessing patients with PsA for spinal involvement, it is important to assess both vertebral body lesions and posterolateral lesions, such as inflammation in facet joints and costovertebral joints, and enthesitis at spinous and transverse processes. The Canada-Denmark (CanDen) assessment system for spine MRIs is the preferred method for detailed evaluation of inflammation and structural damage at various anatomical locations in the spine, and it is reproducible and sensitive to change. The Assessment of Spondyloarthritis international Society (ASAS) has recently published MRI definitions of inflammatory and structural lesions in the spine, incorporating the CanDen definitions of spinal lesions on MRI. Applying the ASAS definitions and the CanDen assessment system in clinical practice and trials is recommended. Ongoing research/studies, not least the Axial Involvement in Psoriatic Arthritis (AXIS) study, may provide a data-driven definition of axial involvement in PsA. Ongoing research is expected to further improve and validate assessment tools for axial PsA and to provide a much-needed data-driven consensus-based definition of axial involvement in PsA.
对患有银屑病关节炎（PsA）的患者进行适当评估需要评估所有疾病领域，包括轴性疾病。磁共振成像（MRI）是评估 PsA 轴性受累的首选方法。在评估患有 PsA 的脊柱受累患者时，评估椎体病变和后外侧病变（如关节突关节和肋椎关节的炎症以及棘突和横突处的附着点炎）都很重要。加拿大-丹麦（CanDen）脊柱 MRI 评估系统是详细评估脊柱不同解剖部位炎症和结构损伤的首选方法，其具有可重复性且对变化敏感。最近，脊柱关节炎国际评估协会（ASAS）发布了脊柱炎症和结构病变的 MRI 定义，纳入了 MRI 上脊柱病变的 CanDen 定义。建议在临床实践和试验中应用 ASAS 定义和 CanDen 评估系统。正在进行的研究/研究，尤其是银屑病关节炎的轴性研究（AXIS），可能会为 PsA 的轴性受累提供基于数据的定义。预计正在进行的研究将进一步改进和验证用于评估轴性 PsA 的工具，并为 PsA 的轴性受累提供急需的基于共识的数据驱动定义。
