The radiographic features of psoriatic arthritis (PsA) can be broadly grouped into destructive and proliferative changes.1 Arthritis mutilans, described by Moll and Wright2 as “digital telescoping resulting from severe osteolysis” is the most florid form of erosive disease and occurs in less than 5% of cases. Bony proliferation is also characteristic of PsA and may help differentiate this condition from rheumatoid arthritis. We report a patient with PsA who developed cervical myelopathy as a result of proliferative bony change within the cervical spine, despite extremely severe erosive change at the peripheral joints.

The patient, a 65-year-old man, developed psoriasis at …