The Value of Dce-mri in the Differential Diagnosis of Psoriatic Arthritis and Erosive Osteoarthritis of the Hand

Introduction Psoriatic arthritis (PsA) is a synovial inflammatory arthropathy defined as the occurrence of seronegative arthritis and psoriasis. Psoriatic arthropathy may antedate skin changes in 20% of patients. The peripheral joint involvement in PsA is often asymmetrical and oligoarticular, and can even mimic rheumatoid arthritis [1]. Clinically, it may be difficult to distinguish polyarticular PsA from erosive osteoarthritis (EOA), because both entities share many clinical features, such as the pattern of joint involvement and the involvement of collateral ligaments and tendons [2]. Furthermore, there are few specific diagnostic markers, so that laboratory parameters may not contribute in the differential diagnosis either. In order to prevent serious joint damage, early differentiation of PsA and EOA is important, because new treatment approaches are particularly adapted for each arthritis entity [3]. Recent studies demonstrated that analysis of synovial membrane inflammation by dynamic contrast-enhanced (DCE)-MRI is useful, both in characterization of inflammation activity as well as in the differentiation of arthritis types [4-6]. Therefore, the aim of the present study was to investigate DCE-MRI in the differential diagnosis of PsA and EOA of the hand.