OBJECTIVE: To investigate the potential of ultrasound (US) in the differential diagnosis between rheumatoid arthritis (RA) and psoriatic arthritis (PsA) at metacarpophalangeal (MCP) joints level. METHODS: 18 RA patients and 20 PsA patients with clinical involvement of MCP joints were included. All US examinations were performed by two rheumatologists investigating: presence of joint cavity widening (JCW), synovial fluid and/or synovial hypertrophy, peritenon extensor tendon inflammation (PTI) and intra-articular or peri-tendinous power Doppler (PD) signal. RESULTS: A total of 83 MCP joints in 18 RA patients were assessed. In all of these the authors found different degrees of JCW. 15 of 83 (18%) MCP joints showed synovial fluid, whereas 68 of 83 (82%) MCP joints showed synovial hypertrophy. In 72 of 83 (86.7%) MCP joints intra-articular PD was detected. No PTI pattern was found in these patients. In PsA patients, a total of 82 MCP joints in 20 patients were assessed. 54 of 82 (65.8%) MCP joints showed PTI pattern (p = 0.001). In 50 of these 54 (92.5%) MCP joints extra-articular PD signal was detected (p = 0.001). 28 of 82 (34.1%) MCP joints showed different degrees of JCW. 6 of 28 (21.4%) MCP joints presented synovial fluid, whereas 22 of 28 (78.5%) MCP joints showed synovial hypertrophy. In 8 of 82 (9.7%) MCP joints the JCW and PTI patterns were found contemporaneously. CONCLUSIONS: Preliminary results demonstrate that PTI pattern is a higher characteristic of PsA, which suggests a potential role of US in the differential diagnosis between RA and PsA at MCP joints level.
OBJECTIVE: To investigate the potential of ultrasound (US) in the differential diagnosis between rheumatoid arthritis (RA) and psoriatic arthritis (PsA) at metacarpophalangeal (MCP) joints level. METHODS: 18 RApatients and 20 PsA patients with clinical involvement of MCP joints were included. All US examinations were performed by two rheumatologists investigating: presence of joint cavity widening (JCW), synovial fluid and/or synovial hypertrophy, peritenon extensor tendon inflammation (PTI) and intra-articular or peri-tendinous power Doppler (PD) signal. RESULTS: A total of 83 MCP joints in 18 RApatients were assessed. In all of these the authors found different degrees of JCW. 15 of 83 (18%) MCP joints showed synovial fluid, whereas 68 of 83 (82%) MCP joints showed synovial hypertrophy. In 72 of 83 (86.7%) MCP joints intra-articular PD was detected. No PTI pattern was found in these patients. In PsA patients, a total of 82 MCP joints in 20 patients were assessed. 54 of 82 (65.8%) MCP joints showed PTI pattern (p = 0.001). In 50 of these 54 (92.5%) MCP joints extra-articular PD signal was detected (p = 0.001). 28 of 82 (34.1%) MCP joints showed different degrees of JCW. 6 of 28 (21.4%) MCP joints presented synovial fluid, whereas 22 of 28 (78.5%) MCP joints showed synovial hypertrophy. In 8 of 82 (9.7%) MCP joints the JCW and PTI patterns were found contemporaneously. CONCLUSIONS: Preliminary results demonstrate that PTI pattern is a higher characteristic of PsA, which suggests a potential role of US in the differential diagnosis between RA and PsA at MCP joints level.
Authors: Marwin Gutierrez; Carlos Pineda; Tomas Cazenave; Marco Piras; Gian Luca Erre; Antonella Draghessi; Rossella De Angelis; Walter Grassi Journal: Clin Rheumatol Date: 2014-02-18 Impact factor: 2.980
Authors: Marwin Gutierrez; Cristina Hernandez-Diaz; Lucio Ventura-Rios; Lina María Saldarriaga-Rivera; Santiago Ruta; Magaly Alva; Claudia Mora -Trujillo; Wilkerson Pérez; Henry Terrazas; Rodolfo Del Carmen Arape Toyo; Maritza Quintero; Carla Solano; Oscar Sedano Santiago; Janet Grisel Huamán Sotomayor; Cesar Cefferino; Guillermo E Py; Marcelo J Audisio; Walter Javier Spindler; Horacio Berman; Carla Airoldi; Rómulo Wong; Ana Laura Álvarez Del Castillo Araujo; Mario E Díaz; Carmen Cerón Villaquiran; Rubén Darío Mantilla; José Alexandre Mendonça; Inês Guimarães da Silveira; Aline Defaveri do Prado; Melissa Cláudia Bisi; Violeta Rosario; Jeannette Medrano-Sánchez; Roberto Muñoz-Louis; Ana Cecilia Lozada-Navarro; Araceli Bernal; Maribel Lozano; Carlos Pineda Journal: Clin Rheumatol Date: 2016-08-30 Impact factor: 2.980