Clout of Radiological and Clinical Unity in Axial Psoriatic arthritis and Ankylosing spondylitis discernment In Egyptian patients

Background : Spondylarthritis (SpA) includes a family of diseases that share a common genetic predisposition and several clinical manifestations. This study aimed at clarifying the capability of clinical and radiological features to accurately discriminate between axial psoriatic arthritis (ax-PsA) and ankylosing spondylitis (AS) patients in the Egyptian territories with laying the spotlight upon main point of distinction between the two entities to pave the road for proper management decision. Methods : This prospective study included 480 Egyptian patients recruited from multicenter all over the governorates , divided into two groups (240 ax-PsA and 240 AS) .Every patient was subjected to clinical examination , X-ray and MR of the whole spine and sacroiliac joints. Results Clinical divergence was noted between the two SpA groups. MR sacroiliac and spinal changes in Active inflammation, were more notable in AS patients with (P value of 0.28). Likewise, the structural changes as erosions and fat deposition which were more pronounced in AS patients (P value=0.038 and 0.001 respectively ). On the other hand cervical affection in non- ascending manner was significantly more in PsA patients than AS patients ( of P value<0.001). Conclusions: Disparate radiological and clinical features were conspicuous on juxtaposing ax PsA and Ankylosing spondylitis in Egyptian patients ;backing discernment between those two separate entities - especially in challenging intermingled cases (clinical or radiological) and in cases of delayed appearance of psoriasis skin lesions-, and endorsing capability of convenient management of each.