Psoriasis X-ray

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

## Overview[edit | edit source]

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 periostitis, dactylitis, or arthritis mutilans.

## X-Ray[edit | edit source]

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[edit | edit source]

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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