Rheumatology Clinic, Department of Medical and Biological Sciences, University Hospital Santa Maria della Misericordia, Udine.
Rheumatology Unit, Azienda Sanitaria di Firenze, S. Giovanni di Dio Hospital, Florence.
Rheumatology (Oxford). 2017 Sep 1;56(9):1518-1532. doi: 10.1093/rheumatology/kex179.
To systematically review the role of musculoskeletal US in patients suffering from PsA or psoriasis (Pso) in terms of prevalence, diagnosis, prognosis, monitoring and treatment.
A systematic literature review was conducted through medical databases (MEDLINE via PubMed, Embase) and the grey literature up to September 2015 to inform a new study of the Musculoskeletal Ultrasound Study Group of the Italian Society for Rheumatology. All articles reporting data on musculoskeletal US in PsA or Pso were included and extracted according to the underlying clinical question.
A total of 86 publications were included. The prevalence of US abnormalities showed a wide range for each examined feature (e.g. 37-95% for entheses thickness of the lower limbs). The performance of US for diagnosis of disease or elementary lesions was variable across studies, but no study evaluated the overall performance of US in addition to clinical findings for diagnosing PsA. Considering US in defining PsA and Pso prognosis, several works focused on US of entheses of lower limbs in Pso, while for the monitoring of PsA activity five different scoring systems were identified. Last, the results of the role of US in guiding intra-articular interventions were controversial for the clinical outcomes, but in favour of US for accuracy.
despite the recognized importance of US in the management of PsA and Pso, this review clearly demonstrated the need of pivotal research in order to optimize the use of US in the diagnosis and monitoring of psoriatic disease.
系统回顾肌肉骨骼超声在患有银屑病关节炎或银屑病（Pso）患者中的作用，包括患病率、诊断、预后、监测和治疗。
通过医学数据库（MEDLINE 通过 PubMed、Embase）和灰色文献进行系统文献回顾，检索时间截至 2015 年 9 月，为意大利风湿病学会肌肉骨骼超声研究组的一项新研究提供信息。纳入所有报告肌肉骨骼超声在银屑病关节炎或银屑病中数据的文章，并根据潜在的临床问题进行提取。
共纳入 86 篇文献。每种检查特征的超声异常患病率差异较大（例如，下肢附着点厚度为 37%-95%）。超声在诊断疾病或基本病变方面的性能在不同研究中存在差异，但没有研究评估除临床发现外，超声在诊断银屑病关节炎方面的整体性能。考虑到超声在定义银屑病关节炎和银屑病预后方面的作用，有几项研究集中在银屑病下肢附着点的超声上，而在监测银屑病关节炎的活动方面，确定了五种不同的评分系统。最后，关节内介入治疗中超声的作用的研究结果在临床结果上存在争议，但超声在准确性方面更有优势。
尽管超声在银屑病关节炎和银屑病的治疗中具有公认的重要性，但本综述清楚地表明，需要进行关键性研究，以优化超声在银屑病性疾病的诊断和监测中的应用。
