Musculoskeletal US: Taking the Management of Psoriatic Arthritis to a New Horizon
Yasser El Miedany.
Understanding the disease pathogenesis and tissues structure changes have a positive impact on its
management. In psoriatic patients suffering from arthritis, there is a variable spectrum of pathologic changes that include
joint and tendon inflammation, new bone formation as well as severe osteolysis. This led to the proposition of the term
“psoriatic disease” to encompass the involvement at different tissue and organ levels. The continuous technological
advances in the field of musculoskeletal ultrasound allowed the detailed study of morpho-structural changes of the joints,
entheses as well as skin and nails. Power Doppler Ultrasonography allowed the sensitive detection of blood flow even in
small vessels of superficial tissues which facilitated the assessment of the inflammatory process activity and response to
therapy. The ease of access, ability to scan repeatedly, as well as utility of ultrasound in the assessment of different
musculoskeletal components offer major advantages over MRI and nuclear medicine in standard clinical practice. This
article will review how US imaging has the potential to transform our understanding of psoriasis, and the potential role of
musculoskeletal US, as a sensitive imaging modality, to assess the inflammatory process, disease activity as well as
outcomes of therapy in patients with psoriatic arthritis.
Keywords: Psoriasis, psoriatic arthritis, US, patient reported outcome measures, inflammatory arthritis
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