Psoriatic arthritis Flashcards
1
Q
Radiologic classic findings of PA
A
- Fusiform soft tissue swelling.
- Normal mineralization.
- Dramatic joint space loss.
- Bone proliferation.
- “Pencil-in-cup” erosions.
- Bilateral asymmetrical.
- Affects: hands, feet, SI and spine.
2
Q
Most important difference between psoriatic arthritis and rheumatoid arthritis
A
The differ from each other in many ways, but the most significant difference is the presence of bone formation.
3
Q
Hands involvement of PA
A
- Swelling of the entire digit (Sausage-like dactylitis).
- Transient juxta-articular osteoporosis.
- Normal mineralization is mantained.
- Erosions occur initially at the margins of the joints, with time progresses to involve the central area.
- Erosion may be so extensive, that the joint space may appear to be widened.
- Pencil-in-cup involvement.
- Acro-osteolysis.
- Bone proliferation in four areas: adjacent to erosions, along shafts, across joints and at tendinous and ligamentous insertions.
- May appear as periostitis., exuberant and fluffy in appearance.
- Bone anylosis is common in DIP and PIP.
4
Q
PA patterns in the hands
A
- First: DIP and PIP, sparing of MCP.
- Second: Ray involvement, one to three fingers will be involved and all other joints will be spared.
- Third: Similar to rheumatoid arthritis.
5
Q
Feet involvement of PA
A
- Radiographic finds described in the hand are also found in the feet.
- Distribution: PIP, DIP and MTP.
- Again 1-3 rays may be affected.
- The inferior aspect of the calcaneus may be involved (erosions and bone proliferation).
6
Q
Sacroiliac joints involvement of PA
A
- 50% of PA patients.
- Bilateral and asymmetrical.
- Erosive changes, proliferative bone repair.
7
Q
Spine involvement of PA
A
- Involvement of the lumbar and thoracic spine with paravertral ossification.
- Cervical spine: apophyseal joints are affected with narrowing, erosion, bone proliferation and ocasionally ankylosis.
8
Q
A
