Abstract
The typical X-ray symptoms of psoriatic arthritis (PsA) in joints of hands and distal sections of feet (asymmetric lesions; isolated lesion of distal interphalangeal joints (DIJ) of hands with no changes in other small joints of hands; axial lesion of three joints in a single finger; transverse lesion of joints of the hand at the same level; destruction of distal phalanges; narrowing of the distal epiphysis of hand finger phalanges and metacarpal bones; cup-shaped deformity of the proximal portion of hand finger phalanges and narrowing of distal epiphysis; osseous ankyloses; multiple osteolytic lesions and destruction of bone epiphysis and joint deformities; inflammatory changes in the sacroiliac joints; and typical degenerative changes in the spine) are described. It is especially important to know X-ray manifestations of PsA when there are no typical cutaneous manifestations of psoriasis.
Highlights
Внутрисуставной остеолиз с формированием симптома «карандаш в колпачке» III–V ПЛФ стопы
Осевое поражение трех суставов I, IV и V пальцев, III левого пальца
Summary
The typical X-ray symptoms of psoriatic arthritis (PsA) in joints of hands and distal sections of feet (asymmetric lesions; isolated lesion of distal interphalangeal joints (DIJ) of hands with no changes in other small joints of hands; axial lesion of three joints in a single finger; transverse lesion of joints of the hand at the same level; destruction of distal phalanges; narrowing of the distal epiphysis of hand finger phalanges and metacarpal bones; cup-shaped deformity of the proximal portion of hand finger phalanges and narrowing of distal epiphysis; osseous ankyloses; multiple osteolytic lesions and destruction of bone epiphysis and joint deformities; inflammatory changes in the sacroiliac joints; and typical degenerative changes in the spine) are described. Наиболее часто патологические изменения выявляются в проксимальных и дистальных межфаланговых (ДМФ) суставах кистей и стоп, пястно-фаланговых (ПЯФ) и плюснефаланговых (ПЛФ), крестцово-подвздошных суставах и позвоночнике. При ПсА встречается как сужение, так и расширение суставной щели, при этом последнее чаще выявляется в мелких суставах кистей и дистальных отделов стоп. Часто результатом нейротрофических нарушений являются акроостеолиз ногтевых бугристостей, внутрисуставной остеолиз эпифизов костей и деформации суставов по типу «карандаш в колпачке». Внутрисуставные костные анкилозы, особенно в проксимальных суставах и ДМФ кистей и стоп, являются частыми находками и относятся к патогмоничным симптомам ПсА при исключении травмы и гнойного артрита в пораженном суставе в анамнезе [4–6].
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