Presentation
Right thumb pain. History of chronic skin disease.
Patient Data
Right thumb distal interphalangeal joint shows narrowed joint space, subarticular osteopenia and marginal erosions, more affecting the distal part of the proximal phalanx.
Both feet show extension of the metatarsophalangeal joints and flextion of the interphalangeal joints.
Lateral subluxation of the distal phalanx of the big toes.
Both sacroiliac joints show subarticular sclerosis, and cortical irregularities, suggestive of bilateral sacroiliitis.
Case Discussion
The x-ray findings in combination with a 10-year history of psoriasis are in keeping with psoriatic arthritis. The patient did MRI examination of sacroiliac joints (not uploaded) that showed subarticular bone marrow oedema of the right sacroiliac joint, reflecting active inflammatory arthritis.
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