Ultrasound, magnetic resonance imaging and radiography of the finger joints in psoriatic arthritis patients

Ari Polachek*, Victoria Furer, Mirna Zureik, Sharon Nevo, Liran Mendel, David Levartovsky, Jonathan Wollman, Valerie Aloush, Reut Tzemah, Ofir Elalouf, Marina Anouk, Mark Berman, Ilana Kaufman, Yael Lahat, Hagit Sarbagil-Maman, Sara Borok, Adi Broyde, Lihi Eder, Daphna Paran, Moshe IluzIris Eshed, Ori Elkayam

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives: To report the discrepancies and agreements between US, MRI and radiography of the hand in PsA, and to compare the sensitivity and specificity of US and radiography to MRI as the gold standard imaging study in PsA. Methods: All of the 100 prospectively recruited consecutive PsA patients underwent clinical assessment and concomitant radiographic, US and MRI studies of the MCP, PIP and DIP joints of one hand. Synovitis, flexor tenosynovitis, extensor paratenonitis, erosions and bone proliferations were identified and scored. All readers were blinded to clinical data, and agreement was calculated based on prevalence-adjusted bias-adjusted kappa (PABAK). Results: The prevalence of synovitis, flexor tenosynovitis, extensor paratenonitis and erosions was similar for US and MRI, while that of bone proliferation was significantly increased in US and radiography compared with MRI (P < 0.001). The absolute agreement between US and MRI was good-to-very good for synovitis (85-96%, PABAK = 0.70-0.92), flexor tenosynovitis (93-98%, PABAK = 0.87-0.96) and extensor paratenonitis (95-98%, PABAK = 0.90-0.97). Agreement between US, MRI and radiography was 96-98% (PABAK = 0.92-0.97) for erosions and 71-93% (PABAK = 0.47-0.87) for bone proliferations. Sensitivity of US with MRI as gold standard was higher for synovitis (0.5-0.86) and extensor paratenonitis (0.63-0.85) than for flexor tenosynovitis (0.1-0.75), while the specificity was high for each pathology (0.89-0.98). Conclusion: There is very good agreement between US and MRI for the detection of inflammatory changes in finger joints in PsA. US, radiography and MRI have a good-to-very good agreement for destructive changes.

Original languageEnglish
Pages (from-to)563-571
Number of pages9
Issue number2
StatePublished - 1 Feb 2022


  • destructive change
  • finger joints
  • hand
  • magnetic resonance imaging
  • psoriatic arthritis
  • radiography
  • ultrasound


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