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Psoriasis X-ray

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

There are no X-ray findings associated with psoriasis, though an X-ray can be used to diagnose psoriatic arthritis, which may lead to bone erosion and characteristic “pencil-in-cup” deformities. Psoriatic arthritis may also lead to periostitisdactylitis, or arthritis mutilans.

X-Ray

There are no X-ray findings associated with psoriasis, though an X-ray can be used to diagnose psoriatic arthritis, which may lead to bone erosion and characteristic “pencil-in-cup” deformities.

  • Key X-ray findings in cases of psoriatic arthritis include:[1][2][3]
    • Enthesitis and marginal bone erosions
    • “Pencil-in-cup” deformities
    • Interphalangeal ankylosis may be found
    • Bone proliferation leads to inflammatory bone spur formation around the affected joints
    • Periostitis: Appears as a periosteal layer of new bone, or as irregular thickening of the cortex itself
    • Dactylitis: Which can present as a “sausage digit” which refers to soft tissue swelling of a whole digit
    • Arthritis mutilans: It may lead to “telescoping of fingers” caused by marked bony resorption and the subsequent collapse of soft tissue
    • Asymmetrical sacroiliitis
    • Spondylitis: Asymmetric paravertebral ossifications and relative sparing of the facet joints
Pencil-in-cup deformity of metacarpophalygeal joints

References

  1. Sankowski AJ, Lebkowska UM, Cwikła J, Walecka I, Walecki J (2013). “Psoriatic arthritis”. Pol J Radiol. 78 (1): 7–17. doi:10.12659/PJR.883763. PMC 3596149. PMID 23493653.
  2. Mease PJ, Armstrong AW (2014). “Managing patients with psoriatic disease: the diagnosis and pharmacologic treatment of psoriatic arthritis in patients with psoriasis”. Drugs. 74 (4): 423–41. doi:10.1007/s40265-014-0191-y. PMC 3958815. PMID 24566842.
  3. Haddad A, Chandran V (2013). “Arthritis mutilans”. Curr Rheumatol Rep. 15 (4): 321. doi:10.1007/s11926-013-0321-7. PMID 23430715.

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