To the Editor:
We thank Garcia-Valladares and colleagues for their comments1 on our report2. We appreciate that they noted improvement in radiological features following treatment with etanercept. The point of our report was not only to demonstrate the impressive improvement in the patient we observed, but to describe the formal radiology reading techniques in recognizing the improvement. We believe that at least the modified Steinbrocker method can be used in clinical practice to appreciate disease modification among patients with psoriatic arthritis treated with anti-tumor necrosis factor agents.