الفهرس 
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Abstract
Psoriasis (PsO) is a multisystem inflammatory disease with a predominantly skin involvement. The most common clinical type is the chronic plaque PsO which is characterized by well-demarcated, symmetric, and erythematous plaques with overlying silvery scales and positive Auspitz’s sign.
Psoriatic arthritis (PsA) is a common rheumatic disease that occurs in up to one-third of patients with PsO. It is considered a part of the spectrum of seronegative spondyloarthropathies (SpA). Early recognition and therapeutic interventions are critical for preventing destructive and debilitating changes of the disease.
The aim of this study was to assess the importance of musculoskeletal ultrasound (MSKUS), magnetic resonance imaging (MRI) and serum C–X–C motif chemokine 10 (CXCL-10) in early detection of psoriatic SpA in patients with skin PsO.
This cross-sectional study included 80 patients with skin or scalp PsO above the age of 18 years. Patients were selected from hospital based bi-centers: Menoufia University Hospitals and Shebin El-Kom Teaching Hospital and were diagnosed clinically by an experienced dermatologist. Forty patients were selected and grouped as having arthralgia (group I) and compared with another 40 patients without arthralgia (group II). All the patients were subjected to the following: - Detailed history taking - Complete clinical examination with emphasis on measuring the body mass index (BMI), assessment of extent of skin disease and the articular examination. - Comprehensive MSKUS assessments of 36 regions (peripheral joints and enthuses). For each patient, total, inflammatory and damage scores of Madrid Sonographic Enthesitis Index (MASEI) were calculated. - MRI of sacroiliac joints (SIJs) using Short Tau Inversion Recovery (STIR) technique - Laboratory investigations: rheumatoid factor (RF), C-reactive protein (CRP), serum uric acid (SUA) and C–X–C motif chemokine 10 (CXCL-10). The study results could be summarized as follows: - The total psoriatic population aged 18 to 66 years and the female-to-male ratio was 55% to 45%, with a disease duration range of 1 to 360 months. - BMI was significantly increased among the patients in group I compared with group II. - Patients of group I showed increased tender joint and entheseal counts. Also, 45% of them had positive clinical testing for sacroiliitis. - According to the findings of MSKUS and MRI, our psoriatic population could be differentiated into 4 new categories named early PsA (ePsA), PsO with arthralgia (PsOAr), PsO with enthesopathy (PsOE) and patients with pure skin disease (PsO) - Twenty-four patients of group I demonstrated evidence of inflammatory articular disease in the form of active (power Doppler) synovitis, enthesits and bone marrow edema of the SIJs. Hence, satisfaction of CASPAR criteria and early classification of early PsA (ePsA) could be established before clinical signs of inflammation appear. Our study could detect PsA in its transition phase which is called “prodromal PsA”.