PT  - JOURNAL ARTICLE
AU  - Yasser Emad
AU  - Yasser Ragab
AU  - Tamer Gheita
AU  - Ashraf Anbar
AU  - Hoda Kamal
AU  - Ahmed Saad
AU  - Hanan Darweesh
AU  - Nashwa El-Shaarawy
AU  - Amr Azab
AU  - Ahmed Ismail
AU  - Johannes J.  Rasker
AU  - Knee Enthesitis Working Group
TI  - Knee Enthesitis and Synovitis on Magnetic Resonance Imaging in Patients with Psoriasis without Arthritic Symptoms
AID  - 10.3899/jrheum.120301
DP  - 2012 Aug 01
TA  - The Journal of Rheumatology
PG  - jrheum.120301
4099  - http://www.jrheum.org/content/early/2012/07/26/jrheum.120301.short
4100  - http://www.jrheum.org/content/early/2012/07/26/jrheum.120301.full
AB  - Objective This case-control study was designed to evaluate magnetic resonance imaging (MRI) findings of knee joints in patients with psoriasis without clinical peripheral or axial joint involvement, and to correlate MRI findings with disease and demographic variables. Methods In total 48 patients with psoriasis and no clinical evidence of synovitis or enthesitis in any peripheral or axial joints were enrolled. A random sample of 20 healthy subjects without knee or other joint complaints and matched for age and sex served as controls. All patients and controls underwent enhanced MRI studies of both knee joints, and MRI findings were compared. Results Among 48 patients (96 knees), a total of 90 entheseal lesions were detected, with no enthesitis in 2 cases (6.3%). Signs of continuing inflammation bilaterally were frequently found: soft tissue edema (STE; n = 52), bone marrow edema (BME; n = 20), perientheseal BME (n = 3), cartilaginous erosions (n = 42), and bone erosions (n = 27). In controls, 2 (10%) subjects had BME and another 5 (25%) showed cartilaginous erosions. None showed evidence of enthesitis. Significant correlations were observed between the number of entheseal lesions of both knees vs STE (present vs absent; r = 0.314, p = 0.030) and STE (number of lesions; r = 0.351, p = 0.014). Enthesitis (unilateral vs bilateral) was significantly and positively correlated with STE (r = 0.304, p = 0.036), cartilaginous erosions (r = 0.304, p = 0.036), and villous projections (r = 0.347, p = 0.016). Conclusion Subclinical synovitis and enthesitis are frequently found in the knee joint of patients with psoriasis. These may be an early sign of psoriatic arthritis.