Dual-energy CT (DECT) Iodine Map can assess the detailed anatomic sites of the inflammatory hand lesions, which coincided with enthesis, in hand psoriatic arthritis (PsA), according to study results published in European Journal of Radiology Open.

Researchers used DECT Iodine Map to image 38 anatomic landmarks that were potential inflammatory sites in the thumb and middle finger of patients with symptomatic PsA. Contrast-enhanced magnetic resonance images and macroscopic specimens of the thumb and middle finger were also prepared from a cadaver, as a reference.

Overall, 22 patients with PsA were included with a mean age of 54.8±17.6 years and mean duration of psoriasis and joint symptoms of 11.8±11.3 years and 19.5±35.6 months, respectively. The frequently observed sites of inflammation were classical or functional entheses, which coincided with the hypothesis that the primary inflammation sites in patients with PsA were entheses. Researchers also noted remarkable enhancement (13.6%-45.5%) around the distal interphalangeal joints.


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Study limitations included the possibility that references from the cadaver were affected by formalin-alcohol fixation and that only the thumb and middle finger of patients with PsA were examined.

Researchers concluded, “…DECT Iodine Map could be a valid tool in [the] evaluation of detailed inflammatory sites of PsA.”

Reference

Ogiwara S, Fukuda T, Kawakami R, Ojiri H, Fukuda K. Anatomical analysis of inflammation in hand psoriatic arthritis by dual-energy CT Iodine Map. Eur J Radiol Open. 2021;14;8:100383. doi:10.1016/j.ejro.2021.100383