Psoriatic arthritis (PsA) can lead to joint damage and functional impairment and is characterized by a pattern of bone remodeling that includes bone resorption and new bone formation. This includes periostitis, syndesmophytes, and more. Delayed diagnosis can lead to significant structural damage, with arthritis mutilans representing the most severe and deforming disease phenotype. Imaging evaluates disease progression, with radiography remaining the most widely used modality; conventional radiographic scoring systems often omit features like new bone formation and are limited in assessing soft tissue abnormalities, including bursitis, enthesitis, and more. Imaging can detect PsA-related changes earlier and more accurately.

Imagining like high-resolution ultrasound and magnetic resonance imaging offer improved sensitivity for identifying inflammatory and structural lesions. These tools are recognized for their role in enhancing early PsA detection, assessing disease severity, and monitoring treatment response. Imaging also identifies individuals with psoriasis who are at boosted risk for developing PsA, contributing to a more individualized disease management approach. This review explores imaging in PsA and how it’s changing, with an emphasis on diagnostic precision, prognostic value, and how it leads therapeutic strategies.

Reference: Jin Y, Cheng IT, Wu D, Yan X, et al. Imaging in psoriatic arthritis: established methods and emerging techniques. Ther Adv Musculoskelet Dis. 2024 Oct 16;16:1759720X241288060. doi: 10.1177/1759720X241288060. PMID: 39421802; PMCID: PMC11483715.