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Psoriatic arthritis: lessons from imaging studies and implications for therapy
Ashish J Mathew1, Laura C Coates2, Debashish Danda1
1a Clinical Immunology & Rheumatology , Christian Medical College , Vellore , India.
Expert Review of Clinical Immunology
|August 5, 2016
Summary
Modern imaging techniques like MRI and ultrasound can help diagnose, predict outcomes, and monitor treatment response in psoriatic arthritis (PsA). These tools detect subclinical disease and guide therapy adjustments, improving patient management.
Area of Science:
- Rheumatology
- Radiology
- Medical Imaging
Background:
- Psoriatic arthritis (PsA) diagnosis, prognosis, and treatment monitoring can be enhanced by modern imaging modalities.
- Whole body magnetic resonance imaging (MRI) and ultrasound (US) are key technologies for detecting osteitis, enthesitis, and other pathologies in PsA.
- Subclinical disease in psoriasis and PsA is increasingly recognized, impacting diagnostic criteria and treatment classification.
Purpose of the Study:
- To review the role of modern imaging in psoriatic arthritis (PsA).
- To highlight the utility of ultrasound and MRI in evaluating joint and extra-articular manifestations of PsA.
- To discuss the implications of imaging for treatment decisions, including biologic tapering.
Main Methods:
- Review of current literature on advanced imaging techniques in PsA.
- Focus on ultrasound (US) for clinic-based assessments of joint and entheseal inflammation.
- Discussion of whole body MRI for comprehensive disease evaluation.
Main Results:
- Ultrasound effectively visualizes joint pathology and extra-articular features like enthesitis, skin, and nail disease in PsA patients.
- Imaging can identify subclinical disease in individuals with psoriasis and PsA, suggesting broader disease activity.
- Modern imaging may inform decisions regarding the tapering of biologic therapies, although further clinical validation is needed.
Conclusions:
- Increased utilization of advanced imaging is expected with novel PsA therapies.
- Imaging biomarkers require further validation as responsive outcome measures in PsA clinical trials.
- Modern imaging offers valuable insights for diagnosis, prognosis, and therapeutic monitoring in psoriatic arthritis.
