Türk Osteoporoz Dergisi (Aug 2016)
Psoriatic Arthritis in Psoriasis Patients: Evaluation of Clinical and Radiological Features
Abstract
Objective: The purpose of this study was to perform radiological and clinical determination of the presence of psoriatic arthritis (PsA) in patients with psoriasis and to evaluate associations with clinical findings. Materials and Methods: The medical files of 72 patients with psoriasis presenting to our clinic between years 2009-2014 with a pre-diagnosis of PsA were reviewed retrospectively. Hand, foot and sacroiliac joint radiograms were evaluated by a radiologist who was blinded to the patient’s clinical status and who is experienced on musculoskeletal radiology. Patients with psoriasis were divided into two groups according to the presence of arthritis which was determined based on radiographic findings or on Classification Criteria for Psoriatic Arthritis (CASPAR) criteria. All patients’ demographic characteristics, length of disease, nail involvement, smoking-alcohol consumption were recorded. Results: The mean age of all patients was 47.24±14.61 years, and the mean duration of disease was 14.13±11.92 years. Smoking and alcohol consumptions were determined in 54.2% (n=39) and 23.6% (n=17) of the cases, respectively. Nail involvement was determined in 56.9% (n=41) of the cases. PsA was determined based on radiological findings in 58.3% (n=42) of the patients. The mean age and age at onset of disease were higher in PsA (+) patients than in radiologically non-PsA subjects. Based on clinical findings, PsA based on CASPAR criteria was determined in only 18.1% (n=13) of all patients. Conclusion: A higher level of PsA was determined using radiological evaluation in this study. The main cause of this condition is the existence of asymptomatic-subclinical patients. A detailed medical history should therefore be taken from patients, and good clinical evaluation is very important. Radiological and clinical evaluation should be performed together in the diagnosis.
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