Magnetic resonance imaging (MRI) evidence of sacroiliitis in skin psoriasis patients: Relation to disease severity

Abstract

BackgroundPsoriasis is a disease of autoimmune imbalance in a genetically susceptible individual. It has a wide range of mild to severe cases. On the contrary to cutaneous affection which attracts the patient attention to seek medical help, articular affection can have a delayed diagnosis. Aim of the workThis study aimed to detect radiologic evidence of sacroiliitis in psoriasis patient not under treatment for articular disease. Patients and methodsTwenty skin psoriasis patients participated in the study. None had been previously diagnosed with articular manifestations related to psoriasis. Imaging of the sacroiliac joint by magnetic resonance imaging- Short TI inversion recovery technique (MRI- STIR technique) was ordered for all patients. The presence of bone marrow edema in T2 weighted image was considered diagnostic of active sacroiliitis. Psoriasis areas and severity index (PASI) score was used to assess skin psoriasis severity. ResultsPatients were 11 female and 9 males with mean age of 31 ± 5.7 years and mean disease duration of 6.9 ± 3.1 years. The mean PASI score was 19.5 ± 5.2. Clinical sacroiliitis was detected in 25% of patients, plantar fasciitis in 35% and Achilles tendinitis in one patient (5%). MRI with STIR technique was positive for unilateral sacroiliitis showing bone marrow edema in 3 (15%) patients; one male and two females. There was no association between PASI score and presence of radiologic sacroiliitis. ConclusionRadiologic sacroiliitis is not uncommon in skin psoriasis patients not known to have articular involvement and was not related to the skin disease severity.