Imaging in the diagnosis and management of peripheral psoriatic arthritis: Update and recent advances

Psoriatic arthritis is an immune-mediated inflammatory disease characterized by inflammatory and structural changes in multiple clinical domains, including peripheral and axial arthritis, enthesitis, and dactylitis. Early diagnosis and initiation of targeted therapies in patients with PsA lead to a better quality of life. Conventional radiography continues to be the most frequently used imaging modality in routine care, given its easy accessibility and low cost. Advanced imaging techniques, such as ultrasound and magnetic resonance imaging, with their ability to assess both inflammatory and structural pathologies simultaneously, have facilitated a better understanding of disease pathogenesis, early diagnosis leading to early initiation of therapy, sensitive outcome measurement in clinical trials, and close monitoring of the disease process, enabling practical switching of therapies. Novel imaging techniques still seeking broad applicability have demonstrated encouraging results but require further testing before clinical use. This review focuses on the progress in imaging techniques for peripheral psoriatic disease.