Scintigraphy for detecting tumour necrosis factor- on the skin of patients with psoriatic arthritis

Objective: This study assessed the use of scintigraphy and magnetic resonance imaging (MRI) in identifying the presence and amount of tumour necrosis factor- (TNF-) in the joint or skin of patients with psoriatic arthritis, to guide the course of treatment more efficiently.Method: We compared the results of scintigraphy and MRI in two patients with psoriatic arthritis who underwent technetium-99m (Tc-99m)-anti-TNF- scintigraphy, and MRI 5days later.Results: Greater uptake of Tc-99m-anti-TNF- was observed in the left wrist and right second metacarpal in patient 1, and in the left ulnocarpal joint and distal interphalangeal joint of the left first metacarpal in patient 2. These results correlated with the MRI findings.Conclusions: Tc-99m-anti-TNF- scintigraphy may recognize the molecule involved in the inflammatory process. This may provide crucial information to help physicians make decisions about which drugs to use based on biological evidence, and which are cost-effective and appropriate for the treatment of choice. To the best of our knowledge, this is the first time that TNF- has been shown in the skin of a patient using diagnostic imaging methods.