CORRELATIONS BETWEEN PERIPHERAL AND AXIAL RADIOLOGICAL CHANGES IN PATIENTS WITH PSORIATIC POLYARTHRITIS

Peripheral radiological changes were investigated with respect to occu rrence rates, severity and correlations with axial radiological change severity in a retrospective study in 140 patients with psoriatic poly arthritis. Study parameters were the number of erosions in joints of t he hands and feet, severity of wrist lesions, sacroiliitis stage, numb er of syndesmophytes, number of pelvic and calcaneal enthesopathies an d Larsen's damage score. Fifty patients had both peripheral changes an d axial changes (bilateral stage 2 sacroiliitis or unilateral stage 3 or more sacroiliitis and/or syndesmophytes). Disease duration was corr elated with radiological changes and the disease score. When patients were divided into quartiles based on polyarthritis duration, mean dise ase score was found to be significantly higher in the second than in t he first quartile (p < 0.005) and in the fourth than in the third quar tile (p < 0.0005), whereas the difference between the second and third quartiles was not significant. Peripheral changes progressed during t he first five years of the disease. In contrast, the sacroiliitis scor e increased only in those patients with the longest disease durations. Correlations between severity of peripheral changes, sacroiliitis sta ge and disease score were found in all patients. In patients with axia l lesions, peripheral involvement was more common and more severe and disease scores were significantly higher (p < 0.00001). Our findings s uggest that both peripheral and axial changes contribute to the severi ty of psoriatic polyarthritis and that the subgroup of patients with a xial changes is characterized by more frequent and more severe periphe ral lesions.