title: Nail disease in psoriatic arthritis: distal phalangeal bone edema detected by magnetic resonance imaging predicts development of onycholysis and hyperkeratosis.
abstract: OBJECTIVE
  To examine the association between magnetic resonance imaging (MRI) features of distal phalanx (DP) disease and the progression of nail pathology in psoriatic arthritis (PsA).
  
  
  METHODS
  Clinical nail assessment and hand MRI scans were done on 34 patients with PsA. Twenty patients had repeat nail assessments after 1 year.
  
  
  RESULTS
  Nails with onycholysis and hyperkeratosis at baseline were more likely to have corresponding DP bone erosion and proliferation on MRI. DP bone edema on baseline MRI was associated with development of onycholysis and hyperkeratosis in corresponding nails.
  
  
  CONCLUSIONS
  Our data suggest that DP inflammation is central in the development of psoriatic nail disease.
authors.affiliation: Bone Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand. n.dalbeth@auckland.ac.nz
authors.forename: Nicola
authors.initials: N
authors.lastname: Dalbeth
authors.forename: Karen
authors.initials: K
authors.lastname: Pui
authors.forename: Maria
authors.initials: M
authors.lastname: Lobo
authors.forename: Anthony
authors.initials: A
authors.lastname: Doyle
authors.forename: Peter B
authors.initials: PB
authors.lastname: Jones
authors.forename: William J
authors.initials: WJ
authors.lastname: Taylor
authors.forename: Fiona M
authors.initials: FM
authors.lastname: McQueen
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D001847:Bone Diseases / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D001862:Bone Resorption / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D004487:Edema / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D005260:Female; D050278:Finger Phalanges / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D006984:Hypertrophy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D007642:Keratosis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D009262:Nails / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D054039:Onycholysis / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis