Anatomical analysis of inflammation in hand psoriatic arthritis by Dual-Energy CT Iodine Map

OBJECTIVE: This study aimed to identify the detailed location of inflammatory lesions and its frequency of hand PsA on DECT Iodine Map with referring the cadaveric specimen. MATERIALS AND METHODS: Thirty-eight anatomical landmarks were selected as a potential inflammatory sites in the thumb and middle finger. We included 22 symptomatic PsA patients who underwent contrast enhanced DECT of the hand. MR images and macroscopic specimens of thumb and middle finger were prepared from a cadaver. Two musculoskeletal radiologists evaluated DECT with referring the cadaveric images to determine the precise location of inflammatory sites and its frequency. RESULTS: The frequently observed inflammation sites of active PsA patients were either classical or functional entheses, and coincide with the well-known hypothesis that primary inflammatory sites of PsA are enthesis. We have noticed that there was remarkable enhancement around DIP joints (13.6 %–45.5 %). CONCLUSION: DECT could assess the detailed anatomical sites of the inflammatory lesion in hand psoriatic arthritis, which coincided with enthesis.