The OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Scoring System (PsAMRIS): Definitions of Key Pathologies, Suggested MRI Sequences, and Preliminary Scoring System for PsA Hands

Abstract

This article describes a preliminary OMERACT psoriatic arthritis magnetic resonance image scoring system (PsAMRIS) for evaluation of inflammatory and destructive changes in PsA hands, which was developed by the international OMERACT MRI in inflammatory arthritis group. MRI definitions of important pathologies in peripheral PsA and suggestions concerning appropriate MRI sequences for use in PsA hands are also provided.

Imaging in Psoriatic Arthritis

“…7,65 Additional acquisition of T1-weighted sequences after intravenous injection of gadolinium-containing contrast agent can aid identification of inflamed tissue in peripheral joints, and can be done with or without fat suppression. A general agreement on which joints to examine with MRI to assess PsA activity and damage has not been established.…”

“…64,65 Consensus MRI definitions and suggestions concerning appropriate MRI sequences for use in hands with PsA were published in 2009 by the OMERACT MRI Arthritis Working Group. 65 Administration of a contrast agent is optimal for assessment of synovitis and tenosynovitis in peripheral joints, but can be omitted if the aim is to detect bone marrow edema, bone erosions, and bone proliferations. 65 The main inflammatory and structural lesions visualized on MRI in axial PsA are bone marrow edema/osteitis, enthesitis, fat infiltration, bone erosion, bone proliferation, and ankylosis.…”

Polish Medical Society of Radiology and Polish Society of Rheumatology recommendations for magnetic resonance imaging of musculoskeletal disorders in rheumatology*

“…Examples of semiquantitative assessment of inflammatory lesions in the carpal and metacarpophalangeal joints in RA include: RAMRIS (Rheumatoid Arthritis MRI Scoring System) [12], PsAMRIS (Psoriatic Arthritis MRI Scoring System) [13], or the Canadian scoring system for sacroiliac joint inflammation [14].…”

The Need for Biological Outcomes for Biological Drugs in Psoriatic Arthritis

“…This can lead to inaccurate reflections of therapy outcomes, in particular when changes such as enthesitis and extracapsular inflammation more reflective of PsA pathology are not being identified appropriately. Bird, et al used a modified Psoriatic Arthritis Magnetic Resonance Imaging Scoring System (PsAMRIS) scoring method 26 , and confined the analysis to changes within anatomical boundaries such as the tendons (tenosynovitis), joint capsule or synovium (synovitis), and bone (bone edema), and did not look at periarticular inflammation -a characteristic change in PsA.…”