Nail Disease in Psoriatic Arthritis: Distal Phalangeal Bone Edema Detected by Magnetic Resonance Imaging Predicts Development of Onycholysis and Hyper

Nail Disease in Psoriatic Arthritis: Distal Phalangeal Bone Edema Detected by Magnetic Resonance Imaging Predicts Development of Onycholysis and Hyperkeratosis.

Dalbeth N, Pui K, Lobo M, Doyle A, Jones PB, Taylor WJ, McQueen FM.

Source

From the Department of Medicine, University of Auckland, Auckland; Department of Rheumatology, Auckland District Health Board, Auckland; Department of Anatomy with Radiology, University of Auckland, Auckland; Department of Medicine, University of Otago, Wellington; and Department of Molecular Medicine, University of Auckland, Auckland, New Zealand.

Abstract

OBJECTIVE:

To examine the association between magnetic resonance imaging (MRI) features of distal phalanx (DP) disease and the progression of nail pathology in psoriatic arthritis (PsA).

METHODS:

Clinical nail assessment and hand MRI scans were done on 34 patients with PsA. Twenty patients had repeat nail assessments after 1 year.

RESULTS:

Nails with onycholysis and hyperkeratosis at baseline were more likely to have corresponding DP bone erosion and proliferation on MRI. DP bone edema on baseline MRI was associated with development of onycholysis and hyperkeratosis in corresponding nails.

CONCLUSION:

Our data suggest that DP inflammation is central in the development of psoriatic nail disease.

PubMed