The comparison of efficacy of different imaging techniques (conventional radiography, ultrasonography, magnetic resonance) in assessment of wrist joints and metacarpophalangeal joints in patients with psoriatic arthritis

Abstract

SummaryBackground:Psoriatic arthritis (PsA) is a chronic inflammatory joint disease which develops in patients with psoriasis. The rheumatoid factor is characteristically absent in the serum of PsA patients. Etiology of the disease is still unclear but a number of genetic associations have been identified. Inheritance of the disease is multilevel and the role of environmental factors is emphasized. Immunology of PsA is also quite complex. Inflammation is caused by immunological reactions leading to a release of kinins. Destructive changes in bones usually appear after a few months from the onset of clinical symptoms.Material/Methods:PsA typically involves joints of the axial skeleton with an asymmetrical patern. The spectrum of symptoms includes inflammatory changes in attachments of articular capsules, tendons, and ligaments to bone surface. The disease can have a diverse clinical course but usually manifests as oligoarthritis.Results:Imaging plays an important role in the diagnosis of PsA. Classical radiography has been used for this purpose for over a hundred years. It allows to identify late stages of the disease, when bone tissue is affected. In the last 20 years however many new imaging modalities, such as ultrasonography (US), computed tomography (CT) and magnetic resonance (MR), have been developed and became important diagnostic tools for evaluating rheumatoid diseases. They enable the assessment and monitoring of early inflammatory changes.Conclusions:As a result, patients have earlier access to modern treatment and thus formation of destructive changes in joints can be markedly delayed or even avoided.

A review on the accuracy of bladder cancer detection methods

“…The advantages of this method include: (1) it completely eliminates the superimposition of images of structures outside the area of interest; and (2) the statistics gained from one CT image, which comprises multiple contiguous or one helical scan, are considered images in the axial, coronal or sagittal planes, relying on the diagnostic task, which is seen as multi-planar reformatted imaging. The disadvantages of this method include: (1) a slight increase in the risk of cancer in later life via exposure to ionizing radiation (X-rays); (2) its use of higher doses of radiation than normal X-ray scanning makes the risks (while still small) greater than other types in general; and (3) injection of a contrast medium (dye) can lead to kidney insult or allergic reaction 42. Table 6 shows a review of the CT scan method and its sensitivity and specificity.…”

Musculoskeletal Imaging for Dermatologists: Techniques in the Diagnosis and Management of Psoriatic Arthritis

“…The sensitivity of MRI allows the visualization of small, active inflammatory changes and lesions that are present early in the disease course [ 13 , 52 ]. MRI can be used to detect axial or peripheral enthesitis and, like ultrasound, can detect early signs of enthesitis and inflammatory lesions that are not detectable by radiography [ 53 , 54 ].…”

“…MRI can be used to detect axial or peripheral enthesitis and, like ultrasound, can detect early signs of enthesitis and inflammatory lesions that are not detectable by radiography [ 53 , 54 ]. Lesions evident by MRI include thickening of tendons and ligaments, joint effusions and inflammation, bone erosions, enthesophytes, and intraosseous BME [ 27 , 52 ].…”

An intractable case of suspected psoriatic arthritiscombined with Dupuytren’s disease

“…If patients are diagnosed and treated by modern techniques early, formation of destructive changes of joints can be delayed or even avoided. 9 Second, surgery for saving hands function should be performed as soon as possible when joints damage is stabilized. If tendons were not affected, arthroplasty may be a reasonable choice.…”