Department of Rheumatology, Hospital Universitario Severo Ochoa, 28033 Madrid, Spain.
Rheumatology (Oxford). 2011 Oct;50(10):1838-48. doi: 10.1093/rheumatology/ker078. Epub 2011 Jun 23.
To investigate the presence of synovitis, tenosynovitis and enthesitis with power Doppler (PD) ultrasonography (US) in patients with psoriasis without musculoskeletal diseases as compared with controls with other skin diseases without musculoskeletal disorders.
A total of 162 patients with plaque psoriasis and 60 age-matched controls with other skin diseases, all without musculoskeletal diseases, were prospectively recruited at 14 centres. They underwent dermatological and rheumatological assessment and a blinded PDUS evaluation. Clinical assessment included demographics, comorbidities, severity of psoriasis, work and sport activities and musculoskeletal clinical examination. PDUS evaluation consisted of the detection of grey scale (GS) synovitis and synovial PD signal in 36 joints, GS tenosynovitis and tenosynovial PD signal at 22 sites, and GS enthesopathy and entheseal PD signal in 18 entheses.
US synovitis and enthesopathy were significantly more frequent in psoriatic patients than in controls (P = 0.024 and 0.005, respectively). The percentage of joints with US synovitis was 3.2% in the psoriasis group and 1.3% in the control group (P < 0.0005). US enthesopathy was present in 11.6% of entheses in the psoriasis group and 5.3% of entheses in the control group (P < 0.0005). Entheseal PD signal was found in 10 (7.4%) psoriatic patients, whereas no controls showed this finding (P = 0.05). Among demographic and clinical data, having psoriasis was the only significant predictive variable of the presence of US synovitis [odds ratio (OR) 2.1; P = 0.007] and enthesopathy (OR 2.6; P = 0.027).
Psoriatic patients showed a significant prevalence of asymptomatic US synovitis and enthesopathy, which may indicate a subclinical musculoskeletal involvement.
与无肌肉骨骼疾病的其他皮肤病对照者相比，采用能量多普勒超声（PDUS）检查评估无肌肉骨骼疾病的银屑病患者是否存在滑膜炎、腱鞘炎和腱骨附着点炎。
本前瞻性研究共纳入 162 例斑块状银屑病患者和 60 例年龄匹配的无肌肉骨骼疾病的其他皮肤病对照者，所有患者均接受了皮肤科和风湿病学评估以及 PDUS 检查。临床评估包括人口统计学特征、合并症、银屑病严重程度、工作和运动情况以及肌肉骨骼体格检查。PDUS 评估包括 36 个关节的灰阶（GS）滑膜炎和滑膜 PD 信号、22 个部位的 GS 腱鞘炎和腱鞘 PD 信号以及 18 个腱骨附着点的 GS 腱骨附着点病和腱骨附着点 PD 信号。
与对照者相比，银屑病患者的 US 滑膜炎和腱骨附着点病更为常见（P = 0.024 和 0.005）。银屑病组出现 US 滑膜炎的关节百分比为 3.2%，对照组为 1.3%（P < 0.0005）。银屑病组有 11.6%的腱骨附着点出现 US 腱骨附着点病，对照组为 5.3%（P < 0.0005）。10 例（7.4%）银屑病患者出现腱骨附着点 PD 信号，而对照组均未发现（P = 0.05）。在人口统计学和临床数据中，患有银屑病是出现 US 滑膜炎（比值比 [OR] 2.1；P = 0.007）和腱骨附着点病（OR 2.6；P = 0.027）的唯一显著预测变量。
银屑病患者存在无症状的 US 滑膜炎和腱骨附着点病，这可能表明存在亚临床肌肉骨骼受累。
