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Performance of hands and feet radiographs in differentiation of psoriatic arthritis from rheumatoid arthritis
Author(s) -
Ichikawa Naomi,
Taniguchi Atsuo,
Kobayashi Satomi,
Yamanaka Hisashi
Publication year - 2012
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/j.1756-185x.2012.01818.x
Subject(s) - medicine , psoriatic arthritis , rheumatoid arthritis , radiography , osteolysis , rheumatoid factor , arthritis , psoriasis , ankylosis , surgery , dermatology
Aim The purpose of this study was to determine useful radiographic findings for differentiating psoriatic arthritis (PsA) from rheumatoid factor ( RF )‐positive or ‐negative rheumatoid arthritis ( RA ) in Japanese patients. Methods We accrued 85 patients with P s A . Controls included 135 patients with RA (85 RF ‐positive, 50 RF ‐negative) matched for gender and disease duration with P s A patients. Radiographs of hands and feet were obtained, and distal interphalangeal ( DIP ) erosive disease, joint osteolysis, tuft osteolysis, juxta‐articular bony proliferation ( JBP ), periosteal new bone formation and bony ankylosis, which were identified using the definitions developed by an earlier study, were compared between the P s A and RA groups. Results For radiographic features of hands, the frequencies of JBP , periosteal new bone, and diffuse soft tissue swelling of the fingers were significantly higher in P s A patients than in RF ‐positive RA patients. However, only the frequency of JBP significantly differed between P s A and RF ‐negative RA patients. In feet, the frequencies of DIP erosive disease, tuft osteolysis, JBP , and diffuse soft tissue swelling of the toes were significantly higher in P s A patients than in RF ‐positive RA patients. However, only the frequency of JBP significantly differed between P s A and RF ‐negative RA patients. Conclusion JBP was the most important radiographic feature for discriminating P s A from both RF ‐positive and ‐negative RA , confirming the study by the CASPAR group that showed that JBP is the only radiologic feature that can discriminate P s A from other inflammatory arthritides. This study showed the utility of plain radiographs for diagnosis of P s A .