Moshrif Abdelhafeez, Mosallam Ahmed, Mohamed Essam Elden M, Gouda Wesam, Doma Mostafa
Department of Rheumatology, Al-Azhar University School of Medicine, Assiut, Egypt.
Department of Rheumatology and Andrology, Al-Azhar University School of Medicine, Assiut, Egypt.
Eur J Rheumatol. 2017 Mar;4(1):24-28. doi: 10.5152/eurjrheum.2017.16049. Epub 2017 Mar 1.
This study aimed to determine the prevalence of subclinical enthesopathy in patients with psoriasis using power Doppler ultrasonography (PDUS) and its association with other disease parameters.
A total of 50 patients with psoriasis (31 females) aged 19-70 years underwent a thorough clinical examination that included assessment of body mass index (BMI) and psoriasis area and severity index (PASI) score. Measurements of inflammatory markers, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum uric acid, and plain radiography of the heels, knees, and sacroiliac joints were performed for all patients. Patients without clinical evidence of arthritis or enthesitis underwent an ultrasonographic (US) examination. According to the US examination, patients were classified into group I (patients with enthesitis) and group II (patients without enthesitis).
In group I, Achilles enthesis was the most common site of US enthesitis (33.3%), followed by distal patellar enthesis (22.2%), proximal patellar enthesis (16.7%), quadriceps enthesis (16.7%), and plantar aponeurosis enthesis (11.1%). There was a statistically significant positive correlation between the occurrence of enthesitis and the patient's age, disease duration, PASI score, BMI, and hyperuricemia (p<0.05 for each). In contrast, there was no significant correlation between enthesitis and sex or radiographic sacroiliitis (p>0.05 for each).
In addition to the importance of PDUS as a complimentary tool for examining enthesis in patients with psoriasis, the presence of high PASI score, increased BMI and hyperuricemia, and a long disease duration can be considered as predictive parameters for the presence of psoriatic enthesitis.
本研究旨在利用能量多普勒超声（PDUS）确定银屑病患者亚临床附着点病的患病率及其与其他疾病参数的关联。
共50例年龄在19至70岁之间的银屑病患者（31例女性）接受了全面的临床检查，包括体重指数（BMI）评估以及银屑病面积和严重程度指数（PASI）评分。对所有患者进行了炎症标志物、C反应蛋白（CRP）、红细胞沉降率（ESR）、血清尿酸的检测以及足跟、膝关节和骶髂关节的X线平片检查。无关节炎或附着点炎临床证据的患者接受了超声（US）检查。根据超声检查结果，患者被分为I组（有附着点炎的患者）和II组（无附着点炎的患者）。
在I组中，跟腱附着点是超声附着点炎最常见的部位（33.3%），其次是髌腱远端附着点（22.2%）、髌腱近端附着点（16.7%）、股四头肌附着点（16.7%）和足底腱膜附着点（11.1%）。附着点炎的发生与患者年龄、病程、PASI评分、BMI和高尿酸血症之间存在统计学上显著的正相关（每项p<0.05）。相比之下，附着点炎与性别或X线骶髂关节炎之间无显著相关性（每项p>0.05）。
除了PDUS作为检查银屑病患者附着点的辅助工具的重要性外，高PASI评分、BMI增加、高尿酸血症以及病程较长可被视为银屑病性附着点炎存在的预测参数。
