4.6 Review

MRI Findings in Axial Psoriatic Spondylarthritis

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Validity of clinical psoriatic arthritis diagnoses made by rheumatologists in the Swedish National Patient Register

J. K. Wallman et al.

Summary: The validity of clinical ICD-10 diagnoses for PsA in the Swedish NPR is good, with positive predictive values (PPVs) of 69-82% for CASPAR fulfilment and 86% for meeting any established PsA classification criteria.

SCANDINAVIAN JOURNAL OF RHEUMATOLOGY (2023)

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Noninvasive Assessment of Liver Fibrosis by Magnetic Resonance Elastography in Patients with Rheumatic Disease on Long-Term Methotrexate Treatment

Arindam Nandy Roy et al.

Summary: The study aimed to assess the usefulness of magnetic resonance elastography (MRE) in detecting and quantifying liver fibrosis, and to compare these with biochemical parameters. The results showed that MRE provides a reliable, highly accurate, noninvasive assessment of hepatic fibrosis in patients with rheumatic diseases receiving long-term MTX therapy.

INDIAN JOURNAL OF RHEUMATOLOGY (2023)

Review Rheumatology

Telemedicine and psoriatic arthritis: best practices and considerations for dermatologists and rheumatologists

Alice B. Gottlieb et al.

Summary: Telemedicine is increasingly important in the US healthcare system, providing access to healthcare for patients who face geographical and socioeconomic barriers. Psoriatic arthritis (PsA), a common disease, can benefit from telemedicine in terms of improved care and reduced office visits. However, diagnosing PsA remotely remains challenging.

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Review Rheumatology

Psoriatic Spondylitis: A Disease Manifestation in Debate Evidences to Know for the Clinical Rheumatologist

Henning K. Zeidler

Summary: With the development of classification criteria, the terminology and categorization of axial manifestations associated with psoriasis have become more clear. Studies have shown that axial disease in patients with psoriatic arthritis differs demographically, genetically, clinically, and radiographically from ankylosing spondylitis with or without psoriasis.

JCR-JOURNAL OF CLINICAL RHEUMATOLOGY (2022)

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Reply to Dermatoses caused by face mask wearing during the COVID-19 pandemic

F. Bardazzi et al.

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Characterising axial psoriatic arthritis: correlation between whole spine MRI abnormalities and clinical, laboratory and radiographic findings

Pamela Diaz et al.

Summary: Prevalence of inflammatory and structural lesions in patients with psoriatic disease can be assessed using whole spine MRI, but their correlation with clinical features and axSpA classification criteria is poor.

RMD OPEN (2022)

Article Rheumatology

Comparative analysis between ankylosing spondylitis and axial psoriatic arthritis patients

Marwa Mahmoud Abdelaziz et al.

Summary: The study aimed to compare clinical features, disease activity, spinal mobility, and radiographic findings between ankylosing spondylitis (AS) and axial psoriatic arthritis (axPsA) patients. AS patients were more likely to be males, have higher inflammatory back pain, lower peripheral arthritis, more uveitis, higher limitation in spinal mobility measurements, more spinal deformities, and severe radiographic involvement with nearly equal disease activity as in axPsA patients.

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Treating the skin with biologics in patients with psoriasis decreases the incidence of psoriatic arthritis

Maria Laura Acosta Felquer et al.

Summary: The study found that using biologics in patients with psoriasis can reduce the risk of developing psoriatic arthritis (PsA).

ANNALS OF THE RHEUMATIC DISEASES (2022)

Article Rheumatology

Dactylitis Is Associated With More Severe Axial Joint Damage and Higher Disease Activity in Axial Psoriatic Arthritis

Shan-Shan Li et al.

Summary: This study found that patients with axial psoriatic arthritis (axPsA) who had dactylitis had higher disease activity and more severe joint damage compared to those without dactylitis. Careful examination and proper management of axial involvement are recommended.

JOURNAL OF RHEUMATOLOGY (2022)

Review Pediatrics

New Insights on Juvenile Psoriatic Arthritis

Francesco Brunello et al.

Summary: Juvenile psoriatic arthritis (JPsA) is a relatively rare condition in childhood, and recent studies have shown that patients with JPsA can be classified into more homogeneous subgroups based on age of onset, clinical characteristics, and prognosis. Little is known about the genetic and pathogenetic mechanisms of JPsA, and there is a lack of specific clinical trials and therapeutic options for this condition.

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Review Medicine, General & Internal

Diagnosis and Intervention in Early Psoriatic Arthritis

Tomoyuki Hioki et al.

Summary: Psoriatic arthritis is a chronic inflammatory disorder that can cause deformities and joint damage, impacting quality of life. Early diagnosis and intervention are important to prevent permanent disability, but the clinical features overlap with other diseases, making early detection and intervention challenging.

JOURNAL OF CLINICAL MEDICINE (2022)

Meeting Abstract Rheumatology

COMPARISON OF PATIENTS WITH AXIAL PSA AND PATIENTS WITH AXSPA AND CONCOMITANT PSORIASIS

A. Regierer et al.

ANNALS OF THE RHEUMATIC DISEASES (2022)

Review Medicine, General & Internal

Histopathology of Psoriatic Arthritis Synovium-A Narrative Review

Catarina Tenazinha et al.

Summary: Psoriatic arthritis (PsA) is a chronic inflammatory disease with a complex pathogenesis. It shares common features of chronic inflammation with rheumatoid arthritis (RA), such as lining hyperplasia, sublining influx of inflammatory cells, and neoangiogenesis. Recognition of disease-specific histopathologic findings can aid in diagnosis and identification of therapeutic targets.

FRONTIERS IN MEDICINE (2022)

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DO AXIAL PSORIATIC ARTHRITIS PATIENTS MEET ASAS CLASSIFICATION CRITERIA FOR AXIAL SPONDYLOARTHRITIS?

E. Gubar et al.

ANNALS OF THE RHEUMATIC DISEASES (2022)

Article Rheumatology

How well are biologic and conventional DMARDs tolerated in psoriatic arthritis: A real world study

Issrah I. Jawad et al.

Summary: This study retrospectively reviewed the drug survival and tolerability of DMARDs in a large real-world PsA cohort over a 20-year period. The results showed poor tolerability of conventional DMARDs, which should encourage the early use of biologics in the treatment paradigm based on international guidelines.

EUROPEAN JOURNAL OF RHEUMATOLOGY (2022)

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Differences in topographical location of sacroiliac joint MRI lesions in patients with early axial spondyloarthritis and mechanical back pain

Rosa Marie Kiil et al.

Summary: Early diagnostics of axial spondyloarthritis (axSpA) remains a challenge, with traditional imaging techniques being used. By introducing a two-plane assessment system, differences in SIJ MRI changes between early axSpA and mechanical back pain (MBP) patients were analyzed, showing higher BME occurrence in axSpA patients and in the sacrum region for MBP patients. The study findings can help differentiate axSpA patients from other back pain conditions during early diagnosis.

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Comparison of paediatric and adult classification criteria in juvenile idiopathic arthritis during the transition from paediatric to adult care

Anne-Cecile Debrach et al.

Summary: By comparing the classification criteria of juvenile idiopathic arthritis (JIA) patients with those for adults, it was found that systemic JIA tends to fulfill the criteria for adult-onset Still's disease. Different types of JIA may align better with different adult classification criteria.

JOINT BONE SPINE (2021)

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Role of diagnostic imaging in psoriatic arthritis: how, when, and why

Ana Maria Crespo-Rodriguez et al.

Summary: Psoriasis is a common skin disease that can develop into psoriatic arthritis (PsA) in up to 30% of patients, leading to impaired function and reduced quality of life. Early diagnosis and effective treatments are crucial for halting PsA progression. Sensitive imaging techniques such as ultrasound and MRI play an important role in the diagnosis, follow-up, and prognosis of PsA.

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Iwona Sudoł-Szopińska et al.

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Whole-body magnetic resonance imaging vs. clinical evaluation of enthesitis in patients with spondyloarthritis

Zi-Kang Guo et al.

CHINESE MEDICAL JOURNAL (2021)

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Prevalence of Nonradiographic Sacroiliitis in Patients With Psoriatic Arthritis: A Real-life Observational Study

Victoria Furer et al.

Summary: The study found that the prevalence of active sacroiliitis in a real-life sample of patients with PsA was 26%, with a lower prevalence of nonradiographic sacroiliitis (11%) compared to radiographic sacroiliitis (28.7%) in patients with longer disease duration. Inflammatory back pain was not a sensitive indicator for early-stage sacroiliitis.

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A case of psoriatic arthritis triggered by SARS-CoV-2 infection

Lucia Novelli et al.

RHEUMATOLOGY (2021)

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Interleukin-17 and Interleukin-23: A Narrative Review of Mechanisms of Action in Psoriasis and Associated Comorbidities

Alan Menter et al.

Summary: Psoriasis is an immune-mediated inflammatory skin disease associated with inflammatory comorbidities, including increased cardiovascular risk. The IL-23/IL-17 axis plays a central role in the immunopathogenesis of psoriasis and related comorbidities, and selectively inhibiting these cytokines has significant therapeutic benefits for patients with moderate to severe plaque psoriasis.

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The Increased Levels of Fecal Calprotectin in Children With Active Enthesitis Related Arthritis and MRI Signs of Sacroiliitis: The Results of a Single Center Cross-Sectional Exploratory Study in Juvenile Idiopathic Arthritis Patients

Lovro Lamot et al.

Summary: The study found that ERA patients had significantly higher levels of gut inflammation compared to other JIA patients, and this gut inflammation may be related to disease activity and abnormal sacroiliac joint MRI findings. Although NSAID use did not affect fCAL levels, there was a correlation between treatment duration and fCAL concentration.

FRONTIERS IN MEDICINE (2021)

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Efficacy of tofacitinib in reduction of inflammation detected on MRI in patients with Psoriatic ArthritiS presenTing with axial involvement (PASTOR): protocol of a randomised, double-blind, placebo-controlled, multicentre trial

Fabian Proft et al.

Summary: Psoriatic arthritis (PsA) is an inflammatory disease characterized by synovitis, enthesitis, dactylitis and axial involvement. The efficacy of tofacitinib in reducing inflammation in axial PsA patients will be evaluated in a randomized, double-blind, placebo-controlled clinical trial involving 80 participants with active disease.

BMJ OPEN (2021)

Article Rheumatology

Imaging in psoriatic arthritis: Status and recent advances

Ashish J. Mathew et al.

Summary: The heterogeneous nature of PsA poses challenges in disease evaluation, but prompt diagnosis and targeted therapy can help achieve disease remission. Imaging plays a crucial role in PsA, aiding in early diagnosis, better understanding of pathogenesis, and monitoring disease progression.

BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY (2021)

Review Medicine, General & Internal

Main Diagnostic Pitfalls in Reading the Sacroiliac Joints on MRI

Sammy Badr et al.

Summary: MRI examination of the sacroiliac joints is helpful in identifying early axial spondyloarthritis, but it is important to recognize the potential differential diagnoses that can mimic inflammatory sacroiliitis in clinical practice.

DIAGNOSTICS (2021)

Review Rheumatology

Brazilian Society of Rheumatology 2020 guidelines for psoriatic arthritis

Sueli Carneiro et al.

Summary: Psoriatic arthritis is a chronic immune disease characterized by joint and tendon inflammation in patients with psoriasis. The new guidelines offer evidence-based clinical management information for PsA patients.

ADVANCES IN RHEUMATOLOGY (2021)

Review Rheumatology

Sex-associated and gender-associated differences in the diagnosis and management of axial spondyloarthritis: addressing the unmet needs of female patients

Maria-Sole Chimenti et al.

Summary: Emerging evidence suggests that axial spondyloarthritis (axSpA) occurs with roughly equal frequency in women and men, but they experience the disease differently. Female patients often face longer diagnostic delays and greater limitations in physical function, leading to lower treatment adherence.

RMD OPEN (2021)

Article Rheumatology

Axial Disease in Psoriatic arthritis: The presence and progression of unilateral grade 2 sacroiliitis in a psoriatic arthritis cohort

Joy Feld et al.

Summary: This study aimed to assess the presence and radiographic progression of axial psoriatic arthritis, as well as to identify risk factors associated with progression. Axial disease was detected in over 45% of patients, with 52% progressing to the criteria of ankylosing spondylitis within 5.5 years. Younger age, less degenerative disc disease, and more severe psoriasis were associated with progression in this study.

SEMINARS IN ARTHRITIS AND RHEUMATISM (2021)

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Unveiling axial involvement in psoriatic arthritis: An ancillary analysis of the ASAS-perSpA study

D. Benavent et al.

Summary: In this worldwide study, axial PsA was defined as a unique phenotype by rheumatologists, with disease features falling between axSpA and pure pPsA.

SEMINARS IN ARTHRITIS AND RHEUMATISM (2021)

Review Rheumatology

New Perspectives on Diagnosing Psoriatic Arthritis by Imaging Techniques

Mihaela Ionela Sarbu et al.

Summary: Psoriatic arthritis is a chronic inflammatory condition that can result in significant functional impairment and irreversible damage. Diagnosis can be challenging, but utilizing a combination of imaging methods, with ultrasound potentially being the best tool, can improve assessment of structural damage and inflammatory lesions in patients with PsA.

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The Molecular Pathophysiology of Psoriatic Arthritis-The Complex Interplay Between Genetic Predisposition, Epigenetics Factors, and the Microbiome

Ana L. Carvalho et al.

Summary: Psoriasis and psoriatic arthritis are multifactorial disorders characterized by abnormal immune responses in genetically susceptible individuals in the presence of environmental factors, including changes in microbiota and/or epigenetic marks. Understanding the interactions between heritable and acquired pathomechanistic factors contributing to the development and maintenance of psoriasis is crucial for the identification and validation of diagnostic and predictive biomarkers.

FRONTIERS IN MOLECULAR BIOSCIENCES (2021)

Review Medicine, General & Internal

Axial Spondyloarthritis: Mimics and Pitfalls of Imaging Assessment

Antonio Proenca Caetano et al.

Summary: Axial spondyloarthritis (axSpA) is a chronic inflammatory disorder mainly involving the axial skeleton, with imaging findings categorized into active changes and structural changes. MRI plays a key role in detecting subtle or inflammatory changes, while computed tomography is more accurate in depicting bone structural changes.

FRONTIERS IN MEDICINE (2021)

Article Rheumatology

Limited added value of whole spine MRI in spondyloarthritis for disease activity assessment

Ummugulsum Gazel et al.

Summary: The study found that whole spine MRI did not show significant differences in evaluating disease activity between AS and PsA patients, with low confidence levels regarding active inflammation, limiting its value in routine clinical practice.

CLINICAL RHEUMATOLOGY (2021)

Article Rheumatology

Axial involvement in psoriatic arthritis: An update for rheumatologists

Denis Poddubnyy et al.

Summary: Psoriatic arthritis (PsA) is a chronic, inflammatory musculoskeletal disease with heterogeneous characteristics, and axial involvement can lead to complications in management and treatment decisions. The lack of agreed-upon classification and diagnostic criteria for axial PsA complicates the approach to this subset of patients.

SEMINARS IN ARTHRITIS AND RHEUMATISM (2021)

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Post-COVID-19 Arthritis and Sacroiliitis: Natural History with Longitudinal Magnetic Resonance Imaging Study in Two Cases and Review of the Literature

Donatella Colatutto et al.

Summary: COVID-19 can lead to sacroiliac inflammatory involvement, causing symptoms like back pain and showing typical features on MRI. Treatment with NSAIDs can alleviate symptoms, but MRI may remain positive. This study provides valuable insights into post-COVID-19 sacroiliitis.

VIRUSES-BASEL (2021)

Review Medicine, General & Internal

Axial Psoriatic Disease: Clinical and Imaging Assessment of an Underdiagnosed Condition

Ivan Giovannini et al.

Summary: The frequent involvement of the spine and sacroiliac joint in Psoriatic Arthritis (PsA) has led to its classification within the Spondyloarthritis group, although a clear distinction between PsA and Spondyloarthritis remains challenging. Axial involvement, ranging from 25 to 70% in PsA patients, must be taken into consideration alongside peripheral involvement for disease management. The lack of consensus in defining axial involvement in PsA has led to varying interpretations over the years, highlighting a need for improved clinical and radiological assessment.

JOURNAL OF CLINICAL MEDICINE (2021)

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Musculoskeletal Imaging for Dermatologists: Techniques in the Diagnosis and Management of Psoriatic Arthritis

Alice B. Gottlieb et al.

Summary: Early detection and intervention are crucial for patients with psoriatic arthritis, and dermatologists are uniquely positioned to identify symptoms early in the disease process, preventing permanent damage. Multiple musculoskeletal imaging techniques, such as conventional radiography, ultrasound, and magnetic resonance imaging, are essential in the diagnosis and management of psoriatic arthritis.

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The Crucial Questions on Synovial Biopsy: When, Why, Who, What, Where, and How?

Francesca Ingegnoli et al.

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FRONTIERS IN MEDICINE (2021)

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Translational Research Studies Unraveling the Origins of Psoriatic Arthritis: Moving Beyond Skin and Joints

Janne W. Bolt et al.

Summary: Despite advancements in treatment targeting the IL-17/IL-23 and TNF pathways, achieving remission in PsA remains a challenge for some patients. Current prevention of PsA in PsO patients is not possible, highlighting the need for further research on disease pathogenesis to develop more effective treatment strategies.Increased understanding of the early immunological changes in PsA may lead to the identification of novel therapeutic targets to limit disease progression.

FRONTIERS IN MEDICINE (2021)

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Axial Involvement in Psoriatic Arthritis cohort (AXIS): the protocol of a joint project of the Assessment of SpondyloArthritis international Society (ASAS) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)

Denis Poddubnyy et al.

Summary: The AXIS study aims to systematically evaluate clinical and imaging manifestations indicative of axial involvement in patients with PsA, in order to develop classification criteria and a unified nomenclature for defining a homogeneous subgroup of patients for research.

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