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Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients
Published on: March 1, 2024
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Subclinical Synovitis Among Patients With Psoriasis Without Musculoskeletal Involvement: A Systematic Review and
Shanti Mehta1, Grace Xiong2, Dea Metko2
1Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
JAMA Dermatology
|July 16, 2025
Summary
Subclinical synovitis is significantly more common in psoriasis patients without musculoskeletal issues than in healthy individuals. Medical imaging can help identify those at risk of developing psoriatic arthritis.
Area of Science:
- Rheumatology
- Dermatology
- Medical Imaging
Background:
- Psoriasis affects up to 3% of the population, with 30% developing psoriatic arthritis (PsA).
- The transition from psoriasis to PsA is not fully understood.
- Subclinical synovitis precedes PsA and may be detectable via imaging in psoriasis patients without musculoskeletal symptoms.
Purpose of the Study:
- To determine the prevalence of synovitis using ultrasonography and MRI in psoriasis patients without musculoskeletal involvement.
- To compare these findings with healthy controls and patients diagnosed with PsA.
Main Methods:
- A systematic literature search was performed across major databases (MEDLINE, Embase, Scopus, Web of Science) up to October 2024.
- Twelve studies involving 2606 patients (1593 psoriasis, 327 PsA, 686 controls) met the inclusion criteria.
- A random-effects model was used for meta-analysis to pool risk ratios for synovitis prevalence.
Main Results:
- Synovitis was 2.55 times more likely in patients with psoriasis compared to controls.
- MRI detected synovitis more frequently (RR 6.40) than ultrasonography (RR 2.50).
- Synovitis was more frequent in PsA patients than psoriasis patients, though not statistically significant (RR 0.50).
Conclusions:
- Subclinical synovitis is significantly more prevalent in psoriasis patients without musculoskeletal symptoms compared to healthy individuals.
- Medical imaging can identify individuals with psoriasis who may be at higher risk for progressing to psoriatic arthritis.
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