Imaging the joint and enthesis: insights into pathogenesis of psoriatic arthritis.
The distinct radiographic features of psoriatic arthritis (PsA) help confirm it as a distinct entity from rheumatoid arthritis and highlight some unique non-synovial based disease imaging features. The advent of magnetic resonance imaging and a better understanding of joint microanatomy including the complexity of joint entheses provide a unifying anatomical and biomechanical concept that links disease at the apparently disparate sites of involvement in PsA, including the synovium, the enthesis, the bone and the periosteum. These findings suggest a reason for the localisation of disease to skeletal sites that are subject to repeated mechanical stressing.
McGonagle
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Academic Unit Musculoskeletal Diseases, University of Leeds, Calderdale Royal Hospital, Salterhebble, Halifax HX3 0PW, UK. d.g.mcgonagle@leeds.ac.uk
D015535:Arthritis, Psoriatic / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D013585:Synovitis / Q000473:pathology