Both clinical and radiological data should be studied for psoriatic arthritis

Writing in the The Journal of Rheumatology, researchers have investigated the contribution of radiological findings at the initial visit with respect to classifying patients with psoriatic arthritis; and to determine the extent to which the clinical disease patterns change over time. In their prospective study, patients with psoriatic arthritis were reviewed at 6-12 month intervals. A total of 86 patients were enrolled within one year of diagnosis, with follow-up for at least one year. Based on the clinical information, including the actively inflamed joint count, damaged joint count, and the presence of back disease and arthritis mutilans, a clinical psoriatic arthritis pattern was assigned.In addition, a separate radiology pattern, based on radiographs alone, and a combined clinical & radiological pattern, was also assigned at each visit. The initial clinical pattern was compared to both the initial combined clinical-radiological pattern and the clinical pattern at one year and five years in 35 patients with both one- and five-year follow-up records.For 23% of the subjects, the radiological assessment in the initial visit showed evidence of patterns not detected clinically; and 49% and 77% of the patients showed clinical pattern change within one and five years, respectively. A comparison between the group that changed pattern and the one that did not change pattern in five years revealed no significant features. The authors comment that their findings suggest radiological assessment adds information not gained from clinical assessment alone and that clinical patterns do change over time in the majority of patients. They suggest that both these elements must be taken into consideration when developing classification criteria for psoriatic arthritis.Reference...