Department of Rheumatology, School of Health Sciences, University of Thessaly, Larissa, Greece; Center for Molecular Medicine, Old Dominion University, Norfolk, VA.
Semin Arthritis Rheum. 2013 Dec;43(3):325-34. doi: 10.1016/j.semarthrit.2013.04.005. Epub 2013 May 31.
It is increasingly recognized that enthesitis in patients with psoriatic arthritis (PsA) is of clinical importance. We review data on the detection, assessment, and treatment of enthesitis and its related dactylitis in PsA.
We searched Pubmed with the search terms psoriatic arthritis or psoriasis in combination with enthesitis, enthesopathy, and treatment, or enthesitis in combination with imaging.
One hundred fifty-seven papers were selected. Enthesitis occurs frequently in PsA and may be asymptomatic or painful. It can also affect patient's function and quality of life. New imaging modalities, such as ultrasonography and magnetic resonance imaging, have revealed that enthesitis may be the initial osteoarticular inflammatory site in patients with PsA. Enthesitis indices have been developed and should be incorporated in clinical trials. Dactylitis, a characteristic and frequent manifestation of PsA can be tender or not tender and is prognostic of disease progression. Treatment of enthesitis includes non-steroidal anti-inflammatory drugs, classical DMARDs, and adjunctive local steroid injections. In inadequate response, TNFα inhibitors are used.
Enthesitis and dactylitis are important manifestations of PsA, and their evaluation is increasingly used in drug trials and clinical practice.
越来越多的人认识到，银屑病关节炎（PsA）患者的附着点炎具有重要的临床意义。我们回顾了有关附着点炎及其相关的甲周炎在 PsA 中的检测、评估和治疗的数据。
我们使用以下检索词在 Pubmed 中进行检索：银屑病关节炎或银屑病与附着点炎、附着点病和治疗，或附着点炎与影像学相结合。
共选择了 157 篇论文。附着点炎在 PsA 中很常见，可能无症状或疼痛。它还会影响患者的功能和生活质量。新的影像学方法，如超声和磁共振成像，显示附着点炎可能是 PsA 患者最初的骨关节炎炎症部位。附着点炎指数已经开发出来，应该纳入临床试验。甲周炎是 PsA 的一个特征性和常见表现，可以是压痛或无压痛的，并且与疾病进展有关。附着点炎的治疗包括非甾体抗炎药、经典 DMARDs 和辅助局部皮质类固醇注射。在反应不足时，使用 TNFα 抑制剂。
附着点炎和甲周炎是 PsA 的重要表现，其评估越来越多地用于药物试验和临床实践。
