Clinical and radiological assessment of cervical spine in patients with psoriatic arthritis

Psoriatic arthritis is a genetically determined autoimmune disease that affects ligaments, tendons, fascia and joints in at least 5-8% of persons with all types of psoriasis and 1-3% of general population, while it may affect about 20% of patients with seronegative spondyloarthritis with a peak age of onset for PSA between 30-55 years.PSA may be presented by polyarthritis (symmetrical or a symmetrical), asymmetrical oligoarthritis, arthritis of DIP joints of both hands and feet, arthritis mutilans and axial disease (Spondyloarthropathy).PSA patients who have spinal involvement are not symptomatic from their back disease and don’t demonstrate the same degree of limitation of back movement that is noted in patients with Ankylosing spondylitis.Asymmetric sacroiliitis is frequent and is easily identified by computed tomography scanning in up to 1/3 of PSA patients.Axial involvement is most often evident in the neck. Involvement of axial spine results in atlanto-axial and subaxial subluxation, atlanto-axial impaction, apophyseal joint ankylosis and ligament calcification.