Francesca Zuliani1, Alen Zabotti1, Enzo Errichetti2, Ilaria Tinazzi3, Anna Zanetti4, Greta Carrara4, Luca Quartuccio1, Stefania Sacco2, Ivan Giovannini1, Giuseppe Stinco2, Salvatore De Vita5. 1. Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Italy. 2. Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Italy. 3. Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy. 4. Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy. 5. Department of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Italy. salvatore.devita@asuiud.sanita.fvg.it.
Abstract
OBJECTIVES: To evaluate the prevalence of articular/extra-articular inflammatory lesions and structural damage on ultrasonography in patients suffering from psoriasis as well as to assess possible correlations between ultrasonographic elementary lesions and clinical features. METHODS: Psoriatic patients without musculoskeletal symptoms and healthy controls (HCs) were recruited. All patients received a blinded extended ultrasonographic examination of 42 joints, 12 entheses and 32 tendons. Active synovitis was defined by the presence of a grade ≥2 for grey scale (GS) and ≥1 for power Doppler (PD), while active enthesitis corresponded to entheseal hypoecogenicity in GS and entheseal PD signal (<2 mm from bone insertion). RESULTS: Forty psoriatic patients and 20 HCs were included. A total of 2516 joints and 712 entheses were scanned. Active synovitis was found in 11/40 (27.5%) psoriatic patients and 0/20 HCs (p=0.01). Articular synovitis (GS≥2) was more frequent in psoriasis than in HCs [34/40 (85.0%) and 11/20 (55.0%) respectively; p=0.024). Active enthesitis was found only in psoriatic patients, with a prevalence of 20.0% (8/40) (p=0.04). No significant difference in the prevalence of tenosynovitis or paratenonitis was observed between psoriatic patients and HCs. In psoriasis cohort, age was correlated with the presence of active synovitis (p=0.03), while male sex and a higher PASI score were independently correlated with the presence of active enthesitis (p=0.05 and p=0.034, respectively). CONCLUSIONS: Active enthesitis and synovitis could be useful to identify subclinical psoriatic arthritis. This might represent a relevant clinical step to better stratify patients with psoriasis.
OBJECTIVES: To evaluate the prevalence of articular/extra-articular inflammatory lesions and structural damage on ultrasonography in patients suffering from psoriasis as well as to assess possible correlations between ultrasonographic elementary lesions and clinical features. METHODS:Psoriaticpatients without musculoskeletal symptoms and healthy controls (HCs) were recruited. All patients received a blinded extended ultrasonographic examination of 42 joints, 12 entheses and 32 tendons. Active synovitis was defined by the presence of a grade ≥2 for grey scale (GS) and ≥1 for power Doppler (PD), while active enthesitis corresponded to entheseal hypoecogenicity in GS and entheseal PD signal (<2 mm from bone insertion). RESULTS: Forty psoriaticpatients and 20 HCs were included. A total of 2516 joints and 712 entheses were scanned. Active synovitis was found in 11/40 (27.5%) psoriaticpatients and 0/20 HCs (p=0.01). Articular synovitis (GS≥2) was more frequent in psoriasis than in HCs [34/40 (85.0%) and 11/20 (55.0%) respectively; p=0.024). Active enthesitis was found only in psoriaticpatients, with a prevalence of 20.0% (8/40) (p=0.04). No significant difference in the prevalence of tenosynovitis or paratenonitis was observed between psoriaticpatients and HCs. In psoriasis cohort, age was correlated with the presence of active synovitis (p=0.03), while male sex and a higher PASI score were independently correlated with the presence of active enthesitis (p=0.05 and p=0.034, respectively). CONCLUSIONS: Active enthesitis and synovitis could be useful to identify subclinical psoriatic arthritis. This might represent a relevant clinical step to better stratify patients with psoriasis.
Authors: Alen Zabotti; Dennis G McGonagle; Ivan Giovannini; Enzo Errichetti; Francesca Zuliani; Anna Zanetti; Ilaria Tinazzi; Orazio De Lucia; Alberto Batticciotto; Luca Idolazzi; Garifallia Sakellariou; Sara Zandonella Callegher; Stefania Sacco; Luca Quartuccio; Annamaria Iagnocco; Salvatore De Vita Journal: RMD Open Date: 2019-10-23