Chronic Plaque Psoriasis as a Predictor of Spinal Osteoproliferation on Magnetic Resonance Imaging (MRI)

Chronic plaque psoriasis is a systemic inflammatory condition that extends beyond the skin and has been linked to musculoskeletal changes, including excessive bone formation along the spine. Emerging evidence indicates that individuals with psoriasis are more likely to demonstrate spinal bony overgrowth than those without the disease. Although biologically plausible mechanisms have been proposed to explain this relationship, there is currently no clear framework for translating the association into clinical decision-making. Existing practice recommendations do not specify which patients might benefit from spinal magnetic resonance imaging (MRI) evaluation, nor do they clarify whether identifying early, asymptomatic changes influences long-term outcomes. The routine use of MRI is further complicated by its expense, variability in imaging techniques, and the need for adequate clinical suspicion before testing. As a result, its role in standard psoriasis management remains ill-defined. Further investigation is needed to establish uniform imaging criteria, identify high-risk patient subgroups, and assess outcomes over time to determine whether earlier identification of spinal involvement can alter disease trajectories. For now, the value of this review lies in drawing attention to the observed relationship between psoriasis and spinal bone formation, while emphasizing the substantial gaps that must be addressed before this knowledge can inform evidence-based screening or management approaches.