Axial Involvement in psoriatic arthritis patients

What is it about?

The study aimed to investigate spinal involvement in psoriatic arthritis (PsA) patients using clinical and radiographic methods. We included 50 PsA patients. Clinical, functional, and radiographic assessment of the spine were performed. Out of 50 PsA patients (mean age of 45.50 ± 9.90 years), (males and females constituted 27 (54.0%) and 23 (46.0%) respectively), 76% had radiological axial involvement; (26%) with inflammatory axial pain and (50%) without inflammatory axial pain (subclinical). Three axial radiographic patterns were detected including spondylitis without sacroiliitis (15.78%), spondylitis with sacroiliitis (78.94%), and sacroiliitis without spondylitis (5.26%). In axial PsA patients, males were more affected than females (p = 0.003), with older age (p < 0.001) and higher body mass index (BMI) (p = 0.010), increased psoriasis duration (p = 0.007) and severity (p < 0.001), and more spinal movement limitations (p < 0.001). Cervical involvement was higher than lumbar involvement. Axial radiographic severity assessed by the PsA Spondylitis Radiology Index was associated with increased disability as assessed by the health assessment questionnaire (p = 0.001) and decreased quality of life assessed by short form-36 score (p = 0.050). We could conclude that a high percentage of PsA patients had axial involvement with a high percentage having asymptomatic radiological findings. The cervical spine is more often and severely affected than the lumbar spine. Axial PsA occurs in males more than females with characteristic older age and higher BMI, increased psoriasis duration, and more limitation of spinal mobility.

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Photo by Alexander Grey on Unsplash

Photo by Alexander Grey on Unsplash

Why is it important?

These findings may emphasise the significance of clinical and radiographic screening for axial involvement in PsA, since axial involvement was linked to a markedly reduced quality of life and physical function. It helps in detecting subclinical cases and finding the severity of the lesion in patients with psoriatic arthritis.

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