Psoriatic arthritis imaging

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Presentation transcript:

Psoriatic arthritis imaging Dr Tazeen Ahmed Consultant Rheumatologist Croydon Health Services

Hands

More Hands 63 F

More Hands- closer

US hand

US Hand

MRI hands

Right hand sagital fat sat fluid sensitive sequence – marrow fat should be black: Seronegative fingers ring,middle and index – marrow fat should also be low signal but note whole bone of middle phalanges and distal phalanges are edematous not just the periarticular bone.

Left hand same pt seronegative. T1 sequence - marrow should be white as fat is high T1 signal – note dark prox phalanx index finger. Fat Sat sequence same hand: note bright prox phalanx of index finger because edematous

Psoriatic arthritis imaging X-Ray reports can be misleading Difficult to tell the difference between PsA and OA on imaging alone US can distinguish from RA and also OA- but there are overlaps MRI will show bony changes such as osteitis that are not seen on X-ray or US NSAIDs will affect US changes, so please omit for a few days before the scan.