What radiographic features help to differentiate Psoriatic arthritis from other inflammatory diseases

What radiographic features help to differentiate Psoriatic arthritis from other inflammatory diseases?

Historically, 45% to 50% of patients will develop erosions within the first 2 years of their disease, and 67% will eventually develop radiographic changes. Some relatively unique findings in PsA include:

  • • Asymmetric distribution; involvement of DIP joints
  • • Eccentric erosions, periostitis, and bony ankylosis
  • • Relative absence of periarticular osteopenia
  • • Whittling of the phalanges, pencil-in-cup deformity, osteolysis of bones (arthritis mutilans), and erosion of the terminal tufts (acroosteolysis)
  • • Polyarticular unidigit—metacarpophalangeal, proximal interphalangeal (PIP), and DIP of same finger involved
  • • Erosions at entheseal sites
  • • Musculoskeletal ultrasound and/or magnetic resonance imaging showing signs of enthesitis and dactylitis
  • • Sacroiliac and spondylitic changes (usually asymmetric).
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