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a 7 toon ery shoe shinies’ ton U ‘sorren wowed fyaores eaoojope! una “eabunyojeBojpes 19 sauesnase Jo SAC — "A TVA SUIPIRLUV 10d SRL HIOSA XI SSOLLYTINGOD 1K II90 TOA 00 8.6 9 3402, ooo) > .sbeas neva sues tooo toon =3 spe rove ‘toad + pswoxeny sa) ocooa aoe Looog9 > - ‘coaea gioco cra uwretia acon Looe 000 tooo > voaco sees0 —ezor0 olga 4 spueyatouNe oano'> — Jon00% soc0n © so00'0 e000 > oxeo sD $00 eOeD we cone vectos toca t0o0'D Lean © es000 © oom > treo maled.= aera Shera. eo muasO a sujsa.e yo ec apa OMrdls sOUmWIOUN usc “won suo J00u rap suwanes So “snuaqyesod ansuosa i rt u aicos seeoem pue sebum jexSo(pe torsjoq SuONE ION FEVEglo TACCARI, dnt, and axial changes [2,12] suggested that gender influenced the pattern of joint disease. In our patients who were selected based on the presence of peripheral polyarthritis (with or without axial involvement) the rate of occurrence and severity of peripheral radiological changes were similar in males and females, Patients with axial involvement had more wides- pread and more severe arthritic changes than those without saeroiliitis and/or syndesmophytes Consonant with these findings, mean damage score was significantly higher in patients with than without axial involvement. Earlier studies found that polyarticular disease often indicated more severe psoriatic arthritis [2,12,20], and in our patients additional presence of axial involvement defined a subgroup with more numerous and more severe peripheral radiological lesions. Radiological axial changes were fairly common in our study group. Earlier studies have shown that axial iavol- yement with psoriatic arthritis is sometimes detec- table only by routine radiography [20,23]. Our findings demonstrate that peripheral and axial changes in psoriatic arthritis are not independent. The highest sacroliitis stage score was positively correlated with each arthritic change and with the mean damage score in the overall study population and in those patients with axial involvement. Our resulls are at variance with an earlier study that fa led to detect any correlations between peripheral joint disease paiterns and spinal disease progres- sion in psoriatic spondylarthropathy [23] However, this dissonance may be ascribable t0 di ferences in patient selection criteria and in methods of evaluation. ESTUDIO DE LAS CORRELACIONES ENTRE LOS SIGNOS RADIOLOGICOS DE LA AFECCION AXIAL Y PERIFERICA EN EL CURSO DEL REUMATISMO PSORIASICO En este estudio rerospectiv llevado a cabo en 140 pacientes ‘Meciados de ung for pollatialar de reutatismo! pss Go hemos apalzado ln fecuencia y Wn severidad e las 4n0- fmillas radiologieas del esqueleto periferica y se ha Sorel dn ever de Eon el nel Shar Se ealulado part ead pastes, enero de cto Stones en os pres, maton a severiaad de-aeorcion de has Tfevanyegrado de sao, el ndmeco de iniesmoivos, ETnumero ce entesoparias de Ta pelvis y del calcince el frado J afestclon edilogicasegan el adice de Laren, Las KEsionss radiologic perfericas 5 axial (scroll 2 unilateral 3 vo sindesmoteos) se asoctabn 30 ts" Unieamente 1 renpo de evalu de i enferine- i's corel ionaba con moufcacones ragobicas ean el rato dealscacion de Larsen, Los pacientes fueron separa Go segun in antguedad de Ia enfermedad, et 4 gripes con ieee de pacts Ele de Lae Sgt ‘mente superior en el segunda grupo con celacion a primero {O08)"y en e euaro grupo con relaion al erro (pe Hoots) Pot ef covtzari, ao exists cambion sigatienivos ce 8 sepunto y Sener grupo, Mes QUES LEHR so Uagrevan enlos pemeros anos, afecicion de REVUE DU RHUMATISNE ts JANUARY 1996 SPADARO, Valeria RICCIBRE In our patients, disease duration was positively correlated with the severity of peripheral and, to a lesser extent, axial radiological changes, in kee~ ping with previous findings on outcomes in psoria- tic arthritis patients [19,23-25]. However, the tempos of progression of peripheral and axial changes were markedly different. Damage score values increased rapidly during the first five years following disease onset, then showed no further significant increase until disease duration exe ded ten years, The sacroiliitis seore increase, in contrast, proceeded at a slower pace and was signi- ficant only in the highest disease duration quartile, ‘These findings are in keeping with a large series [20] and a longitudinal study [24] that found early development of both clinical and radiological per~ ipheral lesions in psoriatic arthritis patients, follo- wed by slow progression during follow-up [24] Disease duration was longer in patients with spinal disease [20] Concomitant presence of peripheral and axial lesions may define a subgroup of psoriatic arthritis patients with more frequent and more severe joint lesions that may warrant more ageressive therapy, particularly early in the course of the disease. However, current clinical and radiological criteria used for the classification of psoriatic arthritis patients fail to take into account some of the clini- cal, radiological, and prognostic characteristics of the joint manifestations of this pleomorphic disea- se. Consequently, they should be viewed as a preli- minary approach to psoriatic arthritis subset differentiation in furure studies. UNTERSUCHUNG DER ZUSAMMENHANGE ZWISCTIEN DEN AXIALEN UND PERIPUIEREN VERANDERUNGEN IM ROENTGEN BEI PSORIASIS: ARTHRITIS. ly unserer Studie der Rontgencufnalmen von 140 Patenten, die an einer polyareulren form dee Bsaiasls Aris ten tntersuchten wir die Hautigkeit nd don Schweregrad det Verandcrungen des periphezen Skelots In Verbindung mit diem Schineregrad der Veesaderungen des Axialskoles. Bel sien Fattencn wurde che Anzahl dsr Erosonen an Fen ind Hinden, die Schwere der Handgelenkwverinderungen, das Stavium der Sakroilitis, die Anzahl der Syndesmopter die Aa det Enflesopatnen des Beckens und des Kallanous Sawie dor Roontgon-Seore (Latsen-Methode) berechne. Bel 50 Patenten waten im Reenigen sowell periphere als auch dniale Veranderungen a tchen (bilaterale Sakroilits, Stadium 2 oder unilateral Sakroiitts. Stadium 23, und det Syndesmopisten). 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