Physical Medicine and Rehabilitation, Faculty of Medicine, Gazi University, Ankara, Turkey.
Dermatology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Int J Rheum Dis. 2020 Jun;23(6):744-752. doi: 10.1111/1756-185X.13835. Epub 2020 Apr 7.
The primary objective of this study was to assess the ultrasonographic signs of subclinical enthesitis in patients with psoriasis. Secondary objective was to examine the associations between the clinical assessments of enthesitis, severity of psoriasis, and the ultrasonographic signs of enthesitis.
This study included 30 patients with psoriasis who did not have clinically detectable arthritis or enthesitis and 30 healthy volunteers as a control group. In the patient group, PASI, NAPSI, MASES, and SPARCC scores were calculated, and in the control group, MASES and SPARCC scores were calculated. Acute, chronic, and total enthesitis scores were calculated by ultrasonographic examination of the enthesis points that are assessed during calculation of SPARCC score, performed by a researcher blinded to the clinical assessments.
In the ultrasonographic assessment, total enthesitis score was significantly higher in the patient group compared with the control group (P = .04). There was no significant difference between the groups regarding acute or chronic enthesitis scores. NAPSI, PASI, MASES, or SPARCC scores did not show correlation with the ultrasonographically acute, chronic, or total enthesitis scores. There was a low-level correlation between MASES and SPARCC scores in the patient group, which was statistically significant (P = .03). No significant correlation was found between other clinical scores. There was no significant difference between patient and control groups in terms of MASES and SPARCC scores.
Entheseal changes may be frequently observed in patients with psoriasis who are asymptomatic. Musculoskeletal ultrasonography (MUS) may be utilized to detect such abnormalities at the early period.
本研究的主要目的是评估银屑病患者亚临床附着点炎的超声征象。次要目的是检查附着点炎的临床评估、银屑病严重程度与附着点炎超声征象之间的相关性。
本研究纳入 30 例无临床可检测关节炎或附着点炎的银屑病患者和 30 名健康志愿者作为对照组。在患者组中计算 PASI、NAPSI、MASES 和 SPARCC 评分，在对照组中计算 MASES 和 SPARCC 评分。通过对 SPARCC 评分计算过程中评估的附着点进行超声检查，计算急性、慢性和总附着点炎评分，由一名对临床评估不知情的研究人员进行。
在超声评估中，患者组的总附着点炎评分明显高于对照组（P=.04）。两组之间的急性或慢性附着点炎评分无显著差异。NAPSI、PASI、MASES 或 SPARCC 评分与超声急性、慢性或总附着点炎评分均无相关性。在患者组中，MASES 和 SPARCC 评分之间存在低度相关性，具有统计学意义（P=.03）。其他临床评分之间未发现显著相关性。患者组和对照组的 MASES 和 SPARCC 评分无显著差异。
无症状银屑病患者可能经常出现附着点变化。肌肉骨骼超声（MUS）可用于早期检测此类异常。
