Repair of Radiographic Joint Damage Following Treatment with Etanercept in Psoriatic Arthritis Is Demonstrable by 3 Radiographic Methods.

From the Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada.

Abstract

OBJECTIVE: Psoriatic arthritis (PsA) is characterized by varied radiographic features. We describe a patient with PsA with severe radiographic damage that improved significantly following treatment with etanercept. The improvement was documented by several methods of radiographic assessment.

METHODS: Etanercept was introduced in September 2005. Radiographs of the hands and feet were read using 3 methods: the modified Steinbrocker method, the van der Heijde (vdH) modification of the Sharp method, and the Ratingen scoring system.

RESULTS: In July 2009, radiographs of the hands and feet showed improvement in erosion score and joint space narrowing, while bony proliferation remained the same [43 by modified Steinbrocker, 26 by the vdH Sharp score (12 for erosions and 14 for joint space narrowing), and 56 by the Ratingen (18 for erosion and 38 for proliferation].

CONCLUSION: The 3 radiographic methods were useful in demonstrating improvement in joint scores. The modified Steinbrocker method, which is the simplest, was able to reveal improvement in our patient.

三种影像学方法证实依那西普治疗银屑病关节炎有关节修复作用

Eder L, Chandran V, et al,J Rheumatol. 2011 Feb 15. [Epub ahead of print]

目的:银屑病关节炎(PsA) 影像学特征多种多样。我们报告一例有严重影像学破坏的PsA患者经过依那西普治疗后得到显著改善。这种改善经过多种影像学评估方法得以证实。

方法: 2005年9月患者开始应用依那西普。影像学的手足片通过3种方法阅读:改良的Steinbrocker法,Sharp评分中改良的 van der Heijde (vdH)法和Ratingen评分系统。

结果: 2009年7月, 手和足的影像学评估显示侵蚀积分和关节间隙狭窄有所改善,而骨质增生无变化[改良的Steinbrocker法为43，vdH积分为26 (侵蚀评分12，关节间隙狭窄评分14), Ratingen评分系统为56 (侵蚀评分18，增生评分38]。

结论:3种影像学方法都有助于证实关节积分的改善。改良后的Steinbrocker方法最简单，并能显示病人的改善情况。