Modern imaging techniques in the diagnosis of axial spondylitis: similarities and differences between axial psoriatic arthritis and ankylosing spondylitis

Involvement of axial skeletal in psoriatic arthritis (PsA) is often associated with inflammatory changes in peripheral joints and is asymptomatic or minimally symptomatic, and changes in the spine and sacroiliac joints are often found only on X-ray. The article, which is based on numerous studies, compares the characteristics of axial skeletal lesions in patients with the axial form of psoriatic arthritis (axPsA) and in patients with ankylosing spondylitis and discusses the possibilities of their diagnosis using radiography and magnetic resonance imaging (MRI), including modern methods such as diffusion-weighted imaging, contrast-enhanced dynamic scanning and whole-body MRI.The main difficulty in diagnosing axPsA is that there is no universally accepted terminology or standardized diagnostic criteria, making it difficult to clearly distinguish axPsA from other forms of axial spondyloarthritis. Determining the first symptoms of axPsA not only helps to make a timely diagnosis and prescribe appropriate treatment, but also to monitor the activity of the disease and the dynamics of structural changes, which allows appropriate adjustment of the therapy needed to improve the quality of life of patients.