The Definition and Measurement of Axial Psoriatic Arthritis

Ennio Lubrano; Wendy Joanne Parsons; Antonio Marchesoni; Ignazio Olivieri; Salvatore D'Angelo; Alberto Cauli; Francesco Caso; Luisa Costa; Raffaele Scarpa; Luca Brunese

doi:10.3899/jrheum.150634

The Definition and Measurement of Axial Psoriatic Arthritis

J Rheumatol Suppl. 2015 Nov:93:40-2. doi: 10.3899/jrheum.150634.

Affiliations

¹ From the Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso; Rheumatology Department, Istituto Ortopedico G. Pini, Milan; Rheumatology Department of Lucania, "S. Carlo Hospital," Potenza and Madonna Delle Grazie Matera, Potenza and Matera; Rheumatology Unit, Department of Medical Sciences, University of Cagliari, Cagliari; Rheumatology Unit, Department of Medicine DIMED, University of Padua, Padua; and Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.E. Lubrano, MD, PhD, Aggregate Professor of Rheumatology, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; W.J. Parsons, BSc, MPH, Medical Statistician, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Marchesoni, MD, Consultant Rheumatologist, Rheumatology Department, Istituto Ortopedico G. Pini; I. Olivieri, MD, Consultant Rheumatologist and Head of Rheumatology Department, Rheumatology Department of Lucania, "S. Carlo Hospital," and Madonna Delle Grazie Matera; S. D'Angelo, MD, Consultant Rheumatologist, Rheumatology, Department of Lucania, "S. Carlo Hospital," and Madonna Delle Grazie Matera; A. Cauli, MD, PhD, Aggregate Professor of Rheumatology, Rheumatology Unit, Department of Medical Sciences, University of Cagliari; F. Caso, MD, PhD, Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD, Assistant Professor of Rheumatology, Rheumatology Unit, Department of Medicine DIMED, University of Padua; Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; R. Scarpa, MD, Associate Professor of Rheumatology and Head of Rheumatology Department, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Brunese, MD, Chair and Professor of Radiology, Department of Medicine and Health Sciences, University of Molise. enniolubrano@hotmail.
² From the Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso; Rheumatology Department, Istituto Ortopedico G. Pini, Milan; Rheumatology Department of Lucania, "S. Carlo Hospital," Potenza and Madonna Delle Grazie Matera, Potenza and Matera; Rheumatology Unit, Department of Medical Sciences, University of Cagliari, Cagliari; Rheumatology Unit, Department of Medicine DIMED, University of Padua, Padua; and Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.E. Lubrano, MD, PhD, Aggregate Professor of Rheumatology, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; W.J. Parsons, BSc, MPH, Medical Statistician, Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise; A. Marchesoni, MD, Consultant Rheumatologist, Rheumatology Department, Istituto Ortopedico G. Pini; I. Olivieri, MD, Consultant Rheumatologist and Head of Rheumatology Department, Rheumatology Department of Lucania, "S. Carlo Hospital," and Madonna Delle Grazie Matera; S. D'Angelo, MD, Consultant Rheumatologist, Rheumatology, Department of Lucania, "S. Carlo Hospital," and Madonna Delle Grazie Matera; A. Cauli, MD, PhD, Aggregate Professor of Rheumatology, Rheumatology Unit, Department of Medical Sciences, University of Cagliari; F. Caso, MD, PhD, Rheumatology Unit, Department of Medicine DIMED, University of Padua; L. Costa, MD, Assistant Professor of Rheumatology, Rheumatology Unit, Department of Medicine DIMED, University of Padua; Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; R. Scarpa, MD, Associate Professor of Rheumatology and Head of Rheumatology Department, Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Brunese, MD, Chair and Professor of Radiology, Department of Medicine and Health Sciences, University of Molise.

PMID: 26523055
DOI: 10.3899/jrheum.150634

Abstract

This review seeks to update the state of the art of axial psoriatic arthritis (axPsA). The definition and assessment of axPsA can be problematic because no agreement and no definitive data on this topic have been published, resulting in uncertainty as to the best approach to deal with these patients. A few recent scientific reports show new data on the possible coincidence of diffuse idiopathic skeletal hyperostosis and axPsA, as well as on the radiological assessment as measured with the validated instruments for axPsA. Moreover, the role of magnetic resonance imaging has also been evaluated for this intriguing subset. All data confirmed that radiological assessment is a useful tool to detect typical findings of axPsA, while other imaging techniques remain to be validated. Finally, there is no evidence to support treatment of axPsA with traditional disease-modifying antirheumatic drugs, while a "leap" to biologic agents is the only treatment after failure with nonsteroidal antiinflammatory drugs.

Keywords: AXIAL INVOLVEMENT; BATH ANKYLOSING SPONDYLITIS RADIOLOGY INDEX; MODIFIED STOKE ANKYLOSING SPONDYLITIS SPINE SCORE; PSORIATIC ARTHRITIS; PSORIATIC ARTHRITIS SPONDYLITIS RADIOLOGY INDEX; RADIOGRAPHIC SCORING METHODS.

Publication types

Review

MeSH terms

Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Arthritis, Psoriatic / diagnosis*
Arthritis, Psoriatic / diagnostic imaging
Arthritis, Psoriatic / drug therapy
Arthrography
Biological Products / therapeutic use
Decision Support Techniques*
Diagnostic Imaging* / methods
Disability Evaluation
Humans
Joints* / drug effects
Joints* / pathology
Magnetic Resonance Imaging
Predictive Value of Tests
Reproducibility of Results
Severity of Illness Index
Surveys and Questionnaires
Treatment Outcome

Substances

Anti-Inflammatory Agents, Non-Steroidal
Biological Products