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GRAPPA Debate: Is Plain Radiography in Psoriatic Disease Still Necessary?
Isaac T Cheng1, Arthur Kavanaugh2, William Tillett3
1I.T. Cheng, PhD, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
The Journal of Rheumatology
|May 15, 2026
Summary
The necessity of plain radiography in psoriatic disease (PsD) is debated. This article summarizes arguments for and against its continued use in diagnosing and monitoring PsD.
Area of Science:
- Rheumatology
- Radiology
- Medical Imaging
Background:
- Plain radiographs have historically been essential for diagnosing, classifying, and monitoring structural damage in psoriatic disease (PsD).
- Advancements in imaging technologies like ultrasound, MRI, and CT raise questions about the continued relevance of plain radiography in PsD management.
Purpose of the Study:
- To debate the necessity of plain radiography in the current management of psoriatic disease (PsD).
- To present evidence-based arguments for and against the continued use of plain radiographs in PsD.
Main Methods:
- A debate format was held at the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2025 annual meeting.
- Arguments were supported by evidence from clinical trials and other data sources.
Main Results:
- Evidence was presented both supporting and opposing the continued necessity of plain radiography in psoriatic disease.
- The debate aimed to inform the broader PsD community on this evolving imaging question.
Conclusions:
- The role of plain radiography in psoriatic disease requires re-evaluation in light of advanced imaging modalities.
- Further discussion and evidence synthesis are needed to guide clinical practice regarding imaging in PsD.
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