Bibliogr. s. 28-29

Background: Psoriatic arthritis is a chronic inflammatory disease of the joints. Application and diagnostic capabilities of radiography in the diagnostics of rheumatic diseases are widely recognized. The aim of this work is to compare diagnostic efficacy of modern imaging studies (x-ray, ultrasound, MR) in the diagnostics of psoriatic arthritis. Material/Methods: We assessed 50 patients with diagnosed psoriatic arthritis, including 24 women and 26 men aged 20-70 years. They were all subjected to x-ray and ultrasound examinations of carpal and carpometacarpal joints. MR examination of these joints was performed in 16 subjects. The following parameters were assessed: width of the articular gap, presence of synovial hyperplasia, erosions, periosteal reactions, calcifications or effusion. Results of those examinations were later compared. Results: All three methods allowed for similar assessment of articular gap width in the carpal joint (1.86 vs. 2.02 vs. 1.84 respectively for x-ray, ultrasound, MR). MR and ultrasound visualized synovial hyperplasia with similar efficacy. Synovial fold thickness in the carpal joint was 2.91 mm in ultrasound and 2.98 in MR. Assessment of effectiveness in the diagnosis of erosions, periosteal reactions and calcifications revealed superiority of ultrasound and MR over x-ray studies. From a group of 16 subjects, x-ray, ultrasound and MR visualized carpometacarpal erosions in 25% vs. 56.3% vs. 68.8% of patients respectively. Ultrasound and MR studies exhibited similar diagnostic efficacy in the diagnosis of articular effusions. Conclusions: Due to modern imaging techniques we are able to assess changes in the course of psoriatic arthritis earlier and more precisely. Diagnostic efficacy of ultrasound and MR studies in the diagnosis of articular inflammatory lesions is clearly superior to that of x-ray examination. It is particularly important in the beginning phase of the disease. Ultrasound should be used for the diagnostics and patient follow-up. MR examination, as its efficacy is superior to that of ultrasound, should be used for verification in doubtful cases. X-ray examination should remain a method of assessment of bone destruction in advanced, chronic phase of the disease.