Fast Five Quiz: Psoriatic Arthritis Imaging

Herbert S. Diamond, MD


February 01, 2022

Figure 1. Psoriatic arthritis in hand, lateral view x-ray

Plain radiography remains the cornerstone for diagnosing and assessing psoriatic arthritis. The reproducibility of radiographic findings allows for sequential monitoring of patients to gauge disease progression.

MRI is a more sensitive imaging technology but it is a second-line option for monitoring patients with psoriatic arthritis due to its higher cost and lack of widespread availability. MRI is mostly used in cases where inflammation is suspected and when radiographs are not helpful; it also can be used as an adjunct to determine treatment modifications.

Ultrasound is playing an increasing role in psoriatic arthritis. It can be helpful in the differential diagnosis of psoriatic arthritis and can also be used to calculate inflammation in joints and tendons if there is uncertainty upon clinical examination.

CT scan may be used to provide information about the extent and severity of disease, especially in areas that are difficult to evaluate with radiographs, such as the sacroiliac joint, the temporomandibular joint, and the sternum/manubrium. CT is excellent for evaluating bone, depicting bone erosion, sclerosis, and joint space alterations (from narrowing to ankylosis).

Learn more about the use of imaging modalities in psoriatic arthritis.


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