title: The comparison of efficacy of different imaging techniques (conventional radiography, ultrasonography, magnetic resonance) in assessment of wrist joints and metacarpophalangeal joints in patients with psoriatic arthritis.
abstract: BACKGROUND
  Psoriatic arthritis (PsA) is a chronic inflammatory joint disease which develops in patients with psoriasis. The rheumatoid factor is characteristically absent in the serum of PsA patients. Etiology of the disease is still unclear but a number of genetic associations have been identified. Inheritance of the disease is multilevel and the role of environmental factors is emphasized. Immunology of PsA is also quite complex. Inflammation is caused by immunological reactions leading to a release of kinins. Destructive changes in bones usually appear after a few months from the onset of clinical symptoms.
  
  
  METHODS
  PsA typically involves joints of the axial skeleton with an asymmetrical patern. The spectrum of symptoms includes inflammatory changes in attachments of articular capsules, tendons, and ligaments to bone surface. The disease can have a diverse clinical course but usually manifests as oligoarthritis.
  
  
  RESULTS
  Imaging plays an important role in the diagnosis of PsA. Classical radiography has been used for this purpose for over a hundred years. It allows to identify late stages of the disease, when bone tissue is affected. In the last 20 years however many new imaging modalities, such as ultrasonography (US), computed tomography (CT) and magnetic resonance (MR), have been developed and became important diagnostic tools for evaluating rheumatoid diseases. They enable the assessment and monitoring of early inflammatory changes.
  
  
  CONCLUSIONS
  As a result, patients have earlier access to modern treatment and thus formation of destructive changes in joints can be markedly delayed or even avoided.
authors.affiliation: Department of Radiology, Medical Centre for Postgraduate Education, Warsaw, Poland.
authors.forename: Artur Jacek
authors.initials: AJ
authors.lastname: Sankowski
authors.forename: Urszula Maria
authors.initials: UM
authors.lastname: Lebkowska
authors.forename: Jarosław
authors.initials: J
authors.lastname: Cwikła
authors.forename: Irena
authors.initials: I
authors.lastname: Walecka
authors.forename: Jerzy
authors.initials: J
authors.lastname: Walecki
keywords: erosions; exudate; magnetic resonance; plain radiography; psoriatic arthritis; synovial membrane hyperplasia; ultrasonography