Psoriatic arthritis has an incidence of 5,4% in patients with psoriasis. Bony damages and inflammatory disease can affect phalangeal joints The clinical signs of the psoriatic arthritis of phalanxes are swelling of the soft tissues, deformation and functional limitation of the fingers. Articular ultrasound (US) test was evaluated to describe the articular damage, the evolution of the disease and the cyclosporin therapeutic effects.

31 patients with psoriatic arthritis of phalanxes were enrolled in this study. Patients also showed pustolous lesions on the palm and on the plants and painful swelling on the fingers. In all patients 3mg/Kg/die cyclosporin were employed till remission of skin and articular symptoms. Skin and articular lesions were evaluated with PASI and by US test respectively. US test of the skin and joints of the fingers was performed with a GE Sonora Logic 400 MD unit with 7,5-10 MHz probe. The following parameters were considered: length of the phalanxes and shape of articular heads to evaluate bony damages, distance of the intra-articular space and thickness of the extensor tendon and of the dermis and hypodermis covering it to appraise inflammatory process.

US findings showed a “hook” like appearance in distal articular bony heads of phalanxes. Inflammatory damages were indicated by reduction of the intra-articular space and by thickness of the tendon and of the dermis and hypodermis covering it. Cyclosporin produced resolution of skin and articular psoriatic symptoms after 4 an 6 months of therapy in 24 and 7 cases respectively. No symptoms and US inflammatory signs were observed after one year follow-up in 28 cases treated with one cyclosporin therapeutic cycle.