Do patients with skin psoriasis show subclinical axial inflammation on Magnetic Resonance Imaging of the sacroiliac joints and entire spine?

Vlad A Bratu, Peter Häusermann, Ulrich A Walker, Thomas Daikeler, Veronika Zubler, Veronika K Jaeger, Ulrich Weber, Ueli Studler

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Abstract

Objective: To explore potential subclinical involvement of the axial skeleton by magnetic resonance imaging (MRI) of the sacroiliac (SI) joints and the entire spine in patients with skin psoriasis without clinical evidence of peripheral or axial inflammation. Methods: Twenty patients with skin psoriasis but no clinical evidence of peripheral or axial inflammation and 22 healthy controls underwent standardized dermatologic and rheumatologic clinical examination and unenhanced 1.5T MRI of the SI joint and the entire spine. Two blinded readers globally assessed the presence or absence of SI joint inflammation simultaneously on T1-weighted and short tau inversion recovery MRI sequences with a confidence estimate. Bone marrow edema, fat metaplasia, erosion, and ankylosis of the SI joint, and vertebral corner inflammatory lesions and fat lesions were recorded using standardized modules. The prevalence of each lesion type was calculated in both groups, averaged across 2 readers. The number of subjects with lesions in the SI joint and spine (≥1, 2, 3, 4, or 5 lesions) as concordantly assessed by both readers was recorded. Results: The median duration of skin psoriasis was 23.0 years, the median age of patients was 48.5 years, and 25.0% of patients and 9.1% of healthy controls were concordantly classified by both readers as having SI joint inflammation (P = 0.23). The prevalence of bone marrow edema and structural lesions was comparable across patients and controls, both on SI joint and spine MRI. Conclusion: In this controlled study, patients with skin psoriasis but no clinical arthritis or spondylitis showed limited evidence of concomitant subclinical axial involvement by SI joint and spine MRI. These findings do not support routine screening for subclinical axial inflammation in patients with longstanding skin psoriasis.

Original languageEnglish
JournalArthritis Care & Research
Volume71
Issue number8
Pages (from-to)1109-1118
ISSN2151-464X
DOIs
Publication statusPublished - Aug 2019

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Sacroiliac Joint
Psoriasis
Skin
Fats
Skeleton

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Bratu, V. A., Häusermann, P., Walker, U. A., Daikeler, T., Zubler, V., Jaeger, V. K., ... Studler, U. (2019). Do patients with skin psoriasis show subclinical axial inflammation on Magnetic Resonance Imaging of the sacroiliac joints and entire spine? Arthritis Care & Research, 71(8), 1109-1118. https://doi.org/10.1002/acr.23767
Bratu, Vlad A ; Häusermann, Peter ; Walker, Ulrich A ; Daikeler, Thomas ; Zubler, Veronika ; Jaeger, Veronika K ; Weber, Ulrich ; Studler, Ueli. / Do patients with skin psoriasis show subclinical axial inflammation on Magnetic Resonance Imaging of the sacroiliac joints and entire spine?. In: Arthritis Care & Research. 2019 ; Vol. 71, No. 8. pp. 1109-1118.
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title = "Do patients with skin psoriasis show subclinical axial inflammation on Magnetic Resonance Imaging of the sacroiliac joints and entire spine?",
abstract = "Objective: To explore potential subclinical involvement of the axial skeleton by magnetic resonance imaging (MRI) of the sacroiliac (SI) joints and the entire spine in patients with skin psoriasis without clinical evidence of peripheral or axial inflammation. Methods: Twenty patients with skin psoriasis but no clinical evidence of peripheral or axial inflammation and 22 healthy controls underwent standardized dermatologic and rheumatologic clinical examination and unenhanced 1.5T MRI of the SI joint and the entire spine. Two blinded readers globally assessed the presence or absence of SI joint inflammation simultaneously on T1-weighted and short tau inversion recovery MRI sequences with a confidence estimate. Bone marrow edema, fat metaplasia, erosion, and ankylosis of the SI joint, and vertebral corner inflammatory lesions and fat lesions were recorded using standardized modules. The prevalence of each lesion type was calculated in both groups, averaged across 2 readers. The number of subjects with lesions in the SI joint and spine (≥1, 2, 3, 4, or 5 lesions) as concordantly assessed by both readers was recorded. Results: The median duration of skin psoriasis was 23.0 years, the median age of patients was 48.5 years, and 25.0{\%} of patients and 9.1{\%} of healthy controls were concordantly classified by both readers as having SI joint inflammation (P = 0.23). The prevalence of bone marrow edema and structural lesions was comparable across patients and controls, both on SI joint and spine MRI. Conclusion: In this controlled study, patients with skin psoriasis but no clinical arthritis or spondylitis showed limited evidence of concomitant subclinical axial involvement by SI joint and spine MRI. These findings do not support routine screening for subclinical axial inflammation in patients with longstanding skin psoriasis.",
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Do patients with skin psoriasis show subclinical axial inflammation on Magnetic Resonance Imaging of the sacroiliac joints and entire spine? / Bratu, Vlad A; Häusermann, Peter; Walker, Ulrich A; Daikeler, Thomas; Zubler, Veronika; Jaeger, Veronika K; Weber, Ulrich; Studler, Ueli.

In: Arthritis Care & Research, Vol. 71, No. 8, 08.2019, p. 1109-1118.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Do patients with skin psoriasis show subclinical axial inflammation on Magnetic Resonance Imaging of the sacroiliac joints and entire spine?

AU - Bratu, Vlad A

AU - Häusermann, Peter

AU - Walker, Ulrich A

AU - Daikeler, Thomas

AU - Zubler, Veronika

AU - Jaeger, Veronika K

AU - Weber, Ulrich

AU - Studler, Ueli

N1 - This article is protected by copyright. All rights reserved.

PY - 2019/8

Y1 - 2019/8

N2 - Objective: To explore potential subclinical involvement of the axial skeleton by magnetic resonance imaging (MRI) of the sacroiliac (SI) joints and the entire spine in patients with skin psoriasis without clinical evidence of peripheral or axial inflammation. Methods: Twenty patients with skin psoriasis but no clinical evidence of peripheral or axial inflammation and 22 healthy controls underwent standardized dermatologic and rheumatologic clinical examination and unenhanced 1.5T MRI of the SI joint and the entire spine. Two blinded readers globally assessed the presence or absence of SI joint inflammation simultaneously on T1-weighted and short tau inversion recovery MRI sequences with a confidence estimate. Bone marrow edema, fat metaplasia, erosion, and ankylosis of the SI joint, and vertebral corner inflammatory lesions and fat lesions were recorded using standardized modules. The prevalence of each lesion type was calculated in both groups, averaged across 2 readers. The number of subjects with lesions in the SI joint and spine (≥1, 2, 3, 4, or 5 lesions) as concordantly assessed by both readers was recorded. Results: The median duration of skin psoriasis was 23.0 years, the median age of patients was 48.5 years, and 25.0% of patients and 9.1% of healthy controls were concordantly classified by both readers as having SI joint inflammation (P = 0.23). The prevalence of bone marrow edema and structural lesions was comparable across patients and controls, both on SI joint and spine MRI. Conclusion: In this controlled study, patients with skin psoriasis but no clinical arthritis or spondylitis showed limited evidence of concomitant subclinical axial involvement by SI joint and spine MRI. These findings do not support routine screening for subclinical axial inflammation in patients with longstanding skin psoriasis.

AB - Objective: To explore potential subclinical involvement of the axial skeleton by magnetic resonance imaging (MRI) of the sacroiliac (SI) joints and the entire spine in patients with skin psoriasis without clinical evidence of peripheral or axial inflammation. Methods: Twenty patients with skin psoriasis but no clinical evidence of peripheral or axial inflammation and 22 healthy controls underwent standardized dermatologic and rheumatologic clinical examination and unenhanced 1.5T MRI of the SI joint and the entire spine. Two blinded readers globally assessed the presence or absence of SI joint inflammation simultaneously on T1-weighted and short tau inversion recovery MRI sequences with a confidence estimate. Bone marrow edema, fat metaplasia, erosion, and ankylosis of the SI joint, and vertebral corner inflammatory lesions and fat lesions were recorded using standardized modules. The prevalence of each lesion type was calculated in both groups, averaged across 2 readers. The number of subjects with lesions in the SI joint and spine (≥1, 2, 3, 4, or 5 lesions) as concordantly assessed by both readers was recorded. Results: The median duration of skin psoriasis was 23.0 years, the median age of patients was 48.5 years, and 25.0% of patients and 9.1% of healthy controls were concordantly classified by both readers as having SI joint inflammation (P = 0.23). The prevalence of bone marrow edema and structural lesions was comparable across patients and controls, both on SI joint and spine MRI. Conclusion: In this controlled study, patients with skin psoriasis but no clinical arthritis or spondylitis showed limited evidence of concomitant subclinical axial involvement by SI joint and spine MRI. These findings do not support routine screening for subclinical axial inflammation in patients with longstanding skin psoriasis.

U2 - 10.1002/acr.23767

DO - 10.1002/acr.23767

M3 - Journal article

C2 - 30242987

VL - 71

SP - 1109

EP - 1118

JO - Arthritis Care & Research

JF - Arthritis Care & Research

SN - 2151-464X

IS - 8

ER -