Psoriatic arthritis (PsA) is a complex disease that presents in various ways, making its diagnosis and management challenging. Imaging plays a vital role in distinguishing between axial and peripheral PsA and identifying extra-articular involvement like enthesitis and dactylitis. Early diagnosis is key for better clinical outcomes, and selecting the right imaging techniques—such as MRI, ultrasonography (US), and conventional radiography (XR)—helps assess disease activity, structural changes, and inflammation. Advanced imaging methods like high-resolution peripheral computed tomography (HRpQ-CT) and dual-energy computed tomography (DECT) offer more precise evaluations of PsA.

The heterogeneity of PsA makes accurate diagnosis challenging for rheumatologists. Imaging methods like MRI and US are increasingly relied upon to detect inflammation and structural damage, even in asymptomatic patients. Novel techniques like DECT and fluorescence optical imaging (FOI) are being explored to improve diagnostic accuracy and monitor disease progression, especially in the early stages. These advancements are expected to lead to more precise diagnoses and personalized treatment strategies, enhancing PsA management.

Reference: Fassio A, Matzneller P, Idolazzi L. Recent Advances in Imaging for Diagnosis, Monitoring, and Prognosis of Psoriatic Arthritis. Front Med (Lausanne). 2020 Oct 29;7:551684. doi: 10.3389/fmed.2020.551684. PMID: 33195301; PMCID: PMC7658536.