PREVALENCE OF SACROILIITIS IN PSORIATIC PATIENTS

Abstract

Purpose: 1) To assess the prevalence of sacroiliitis in patients with psoriatic skin disease or psoriatic arthritis 2) To study whether this finding precedes the symptom or radiographic change of the peripheral joint which is the hallmark of psoriatic arthritis.

Materials and Methods: Retrospective study was performed in patients diagnosed as psoriasis or psoriatic arthritis between January 1993 and May 1999 who had anteroposterior (AP) film of lumbar spine and/or pelvis and lateral film of lumbar spine available, to evaluate psoriatic bone change. The findings of the sacroiliac (SI) joint were classified into grades 0-4.

Results: Sixty one patients (21 females [mean age 45.3 years] and 32 males [mean age 48.5 years]) were included. Male: female ratio was 1.5:1. Eight patients were excluded from this study due to lack of AP film of pelvis. Prevalence of radiographic sacroiliitis (grade 2 or higher) was 23 of 53 patients (43.4%); among these, 20 had sacroiliitis alone without spinal bone change. The incidence of bilateral symmetrical and asymmetrical sacroiliitis was 46.2% and 53.8%, respectively. In patients with SI abnormalities; such abnormalities preceded the symptom or radiographic change of the peripheral joint in all cases.

Conclusions: The prevalence of radiographic sacroiliitis in this study is 43.4% (23 of 53). Among these 23 patients, SI abnormalities preceded the symptom or radiographic change of the peripheral joint (which is the hallmark of psoriatic arthritis) in all cases. Early detection and diagnosis of psoriatic skeletal involvement may be from the SI joint or the symptom of back pain, which means proper treatment and may help to decrease subsequent complication.

INDEX TERM : Sacroiliac joint ; sacroiliitis Psoriasis