Abstract
Psoriasis may be complicated by inflammatory involvement of peripheral joints, tendons, their sheaths and also diffuse in- flammatory swelling of the whole digit in 10-36% of cases. Therefore, considerable effort is taken to find a sensitive diagnostic tool facilitating an early diagnostics and treatment initiation of this progressive inflammatory disease.
Musculoskeletal ultrasonography (MSUS) is a modern imaging method able to depict joint effusions, synovial hypertrophy, tendons inflammation or enthesitis, cartilage and bone surface defects with high sensitivity. Some of the ultrasound findings are characteristic for psoriatic arthritis and thus, MSUS aids to distinguish patients with psoriatic arthritis from other inflammatory rheumatic diseases.
Beside effusion and synovial hypertrophy also tenosynovitis, paratenonitis along with diffuse inflammation of subsutaneous tissue might be detected by ultrasound. All these signs, when present, are very suspicious of psoriatic arthritis.
Further, enthesitis, nail involvement, skin hypertrophy, erosions or bone irregularities along with reactive osteoproliferative changes also belong to structural signs of psoriatic arthritis. The authors aimed to present here advantages of ultrasonography in detecting subclinical joint involvement in patients with pure skin manifestation of psoriasis.