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Superiority of magnetic resonance imaging over conventional radiography in the early diagnosis of psoriatic arthritis

Dear Editor, Psoriatic arthritis (PsA) is a type of inflammatory arthritis that leads to joint damage and disability if left untreated. Given that psoriatic skin lesions generally precede the onset of arthritic disease, dermatologists have a crucial role in the early detection of PsA. Conventional radiography is the first-line imaging modality for suspected arthritis. Magnetic resonance imaging (MRI) might also be used to assess arthritic disease in patients with PsA because of its sensitivity in detecting changes in both bone and soft tissue. Therefore, we evaluated the usefulness of radiography and MRI in the early detection of PsA. We retrospectively evaluated the clinical records of 18 Japanese patients with PsA diagnosed according to the classification criteria described by the classification criteria for psoriatic arthritis study group. The mean duration of psoriasis and PsA was 8.7 8.1 years (range 0.1–30 years) and 2.7 3.6 years (range 2.4–14 years), respectively. Plain radiographs of the affected hand or foot were taken in posteroanterior and oblique views. MRI of the affected hand or foot was carried out using a 1.5-T scanner (Magnetom Avanto; Siemens Healthcare, Erlangen, Germany), and T1-weighted gadoliniumenhanced images with fat suppression were acquired in the coronal, sagittal and/or axial planes. Eight patients showed abnormalities indicating arthritis on both radiographs and MRI, whereas nine patients had arthritic findings on MRI without any findings on radiographs