{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:45:50Z","timestamp":1787838350406,"version":"build-2784847793"},"reference-count":39,"publisher":"The Journal of Rheumatology","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>(1) To compare clinical characteristics of patients with psoriatic arthritis (PsA) with PsA mutilans (PAM) and without PAM, and (2) to determine the rate of PAM radiographic progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>A retrospective cohort study was conducted of all patients with PsA attending a teaching hospital. The most recent hand and feet radiographs were screened for PAM. Serial radiographs (earliest to most recent) were quantitatively scored for osteolysis, erosion, joint space narrowing, and osteoproliferation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Out of the 610 cases, 36 PsA cases had PAM (5.9%). PAM cases were younger at diagnosis of PsA than non-PAM cases (p = 0.04), had more prevalent psoriatic nail dystrophy (OR 5.43, p &lt; 0.001), and worse health assessment questionnaire score (1.25 vs 0.63, p &lt; 0.04). Radiographic axial disease (OR 2.31, adjusted p = 0.03) and especially radiographic sacroiliitis (OR 2.99, adjusted p = 0.01) were more prevalent in PAM. PAM were more likely than non-PAM cases to have used a disease-modifying antirheumatic drug (DMARD; OR 16.36, p &lt; 0.001). Out of 33 cases, 29 PAM cases had initiated a synthetic DMARD and 4\/13 had initiated anti-tumor necrosis factor (anti-TNF) prior to first demonstration of PAM. A median 5 radiographs were scored for each PAM case (interquartile range 3\u20137). PAM progressed from monoarticular (60%) to polyarticular (80%) involvement. Osteolysis was initially rapid and progressive in the hands and feet, tapering later during disease course. Nail dystrophy predicted more severe osteolysis (p = 0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Compared with non-PAM cases, PAM cases have earlier age at PsA diagnosis, poorer function, more prevalent nail dystrophy, and more radiographic axial disease\/sacroiliitis. The rate of osteolysis is higher in earlier disease, and more severe in those with nail dystrophy. DMARD and anti-TNF therapy appear not to prevent PAM occurrence.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.150083","type":"journal-article","created":{"date-parts":[[2015,5,16]],"date-time":"2015-05-16T02:16:01Z","timestamp":1431742561000},"page":"1169-1176","source":"Crossref","is-referenced-by-count":26,"title":["Psoriatic Arthritis Mutilans: Characteristics and Natural Radiographic History"],"prefix":"10.3899","volume":"42","author":[{"given":"Deepak R.","family":"Jadon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin","family":"Shaddick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Tillett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Korendowych","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Waldron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Cavill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil J.","family":"McHugh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2015,5,15]]},"reference":[{"key":"2018112909342563000_42.7.1169.1","doi-asserted-by":"publisher","DOI":"10.1016\/0049-0172(73)90035-8"},{"key":"2018112909342563000_42.7.1169.2","first-page":"104","article-title":"[A rare variety of chronic rheumatism: opera glass hands]","volume":"36","author":"Marie","year":"1913","journal-title":"Bull Soc Med Hosp Paris"},{"key":"2018112909342563000_42.7.1169.3","unstructured":"Bourdillon C . 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