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Extra-articular processes in osteoarthropathia psoriatica.

H G Fassbender

    Archives of Orthopaedic and Traumatic Surgery. Archiv Fur Orthopadische Und Unfall-Chirurgie
    |October 1, 1979
    PubMed
    Summary

    Psoriatic arthritis involves distinct intra-articular and extra-articular bone processes. The extra-articular bone changes, linked to skin psoriasis, involve proteoglycan loss and unique bone remodeling.

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    Area of Science:

    • Rheumatology
    • Dermatology
    • Pathology

    Background:

    • Osteoarthropathia psoriatica presents complex osteo-articular manifestations.
    • Intra-capsular synovitis in psoriatic arthritis shares features with rheumatoid arthritis, but lacks RA-necroses.
    • Extra-capsular bone changes are a distinct feature of psoriatic arthritis.

    Purpose of the Study:

    • To differentiate and characterize the intra-articular and extra-articular bone processes in psoriatic arthritis.
    • To elucidate the pathological mechanisms underlying the extra-capsular bone changes.
    • To explore the connection between skin and bone manifestations in psoriatic disease.

    Main Methods:

    • Morphological analysis of osteo-articular tissues.
    • Histopathological examination of phalangeal bone.
    • Scintigraphic imaging to correlate bone and skin findings.

    Main Results:

    • Intra-capsular synovitis in psoriatic arthritis is morphologically similar to rheumatoid arthritis, excluding RA-necroses.
    • Extra-capsular bone process involves focal proteoglycan loss and subsequent four-phase bone remodeling without inflammation or osteoclast activity.
    • Scintigraphy suggests a high correlation between the extra-articular bone process and skin lesions, indicating an integral role in psoriatic disease.

    Conclusions:

    • Psoriatic arthritis exhibits two distinct osteo-articular processes: synovitis and a unique extra-capsular bone remodeling.
    • The extra-capsular bone process, initiated by proteoglycan loss, is likely an enzymatic disturbance causally linked to the skin manifestations of psoriasis.
    • The extra-articular bone changes are a significant, often subclinical, component of psoriatic disease.

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