The general features and diagnostic signs of psoriatic arthritis include: asymmetric distribution, soft tissue swelling, normal bone mineralization, erosions, fluffy periostitis, and a narrowed or widened joint space.
In the hands, psoriatic arthritis is usually asymmetric. A ray pattern is usually seen in the DIP joints. Mouse ears sign, pencil in cup deformity, and opera glass hand deformity are also radiographic signs of psoriatic arthritis in the hands and feet. Joint space widening is common due to fibrous tissue deposition and bone destruction.
The sacroiliac joints are involved in up to 50% of patients with psoriatic arthritis. The distribution is usually bilateral, but asymmetric and the joint space is narrowed.
Psoriatic arthritis in the spine is most common in the upper lumbar and lower thoracic area. There is a presence of marginal and non-marginal syndesmophytes, with the latter being the most common. It is usually asymmetric and unilateral.
*All information gathered from Yochum and Rowe's Essentials of Skeletal Radiology - 3rd Edition.
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