CO:04:1 | Bone properties and biomechanics in patients with psoriatic disease: a cross-sectional study with high-resolution peripheral quantitative computed tomography

Anna Piccinelli¹, Francesco Bellinato², Francesco Pollastri¹, Francesco Giorgio¹, Martina Teoni¹, Angelo Fassio¹, Camilla Benini¹, Carmela Dartizio¹, Mattia Tugnolli¹, Davide Gatti¹, Maurizio Rossini¹, Ombretta Viapiana¹, Paolo Gisondi², Giovanni Adami¹. | ¹Rheumatology Unit, University of Verona; ²Dermatology Unit, University of Verona, Italy

Background. Psoriatic disease has a complex effect on bone metabolism, resulting in both pathological bone formation and bone resorption. However, microstructural changes in cortical and trabecular compartment remain poorly understood. The aim of this study was to investigate the prevalence and determinants of bone microarchitectural damage in patients with psoriatic disease.

Methods. We performed a cross-sectional study on patients with Psoriasis (PsO), Psoriatic arthritis (PsA) and age-matched healthy controls (HC) recruited into the department of Dermatology and Rheumatology of AOUI of Verona center. We conducted High-Resolution peripheral Quantitative Computed Tomography (HRpQCT) of the radius and finger joints of the non-dominant hand data. Bone microstructure parameters and Finite Element Analysis (FEA) were calculated.

Results. Fifty-one patients with PsO and thirty-nine patients with PsA were consecutively enrolled in the study. Twenty-four age-matched HC were enrolled as well. Distal radius Bone Mineral Density (BMD) levels were lower in patients with PsA e PsO compared with HC. On distal radius FEA analysis we found a significant reduction of stiffness in PsA compared to both HC and PsO patients. Proximal and distal region of distal interphalangeal (DIP) BMD were lower in PsO compared to PsA. In contrast, PsA patients had lower stiffness and cortical thickness compared to PsO. Nail involvement in psoriatic disease was negatively associated with bone stiffness at the proximal and distal region of DIP.

Conclusions. Psoriatic disease negatively impacts bone integrity, particularly in PsA patients. Patients with psoriatic disease seemed to have lower bone density and more microarchitectural alteration. Nail involvement was associated with decreased bone stiffness in psoriatic disease.