Evaluation of MRI-findings in patients with involvement of psoriatic arthritis (PsA) in small joints in hands and feet. Twenty-five patients with symptomatic joint involvement were studied by MRI. All patients were found to be positive for one or more imaging criteria. Soft tissue oedema was identified in 22/25 (88%) patients. Joint effusion was observed in 23/25 (92%) patients, whereas bone erosion was seen in 20/25 (80%) patients. Bone marrow oedema was evident in 21/25 (84%) cases. In 12/25 (48%) cases, bone proliferation was noted. Tendon sheath effusion was present in 17/25 (68%) patients. Contrast enhancement of the synovia was detected in all patients (n = 25) (100%), whereas adjacent periost was enhanced in 22/25 (88%) and epiphysial bone marrow in 18/25 (72%) patients. MRI allows the assessment of PsA-alterations of soft tissue, cartilage, bone, bone marrow, and adjacent tendon sheath in patients with hand and foot involvement.