Girolimetto Nicolò, Macchioni Pierluigi, Possemato Niccolò, Tinazzi Ilaria, Bascherini Vittoria, Citriniti Giorgia, McConnell Rebecca, Marchetta Antonio, Peluso Rosario, Sabbatino Vincenzo, Salvarani Carlo, Scarpa Raffaele, Costa Luisa, Caso Francesco
Department of Clinical and Experimental Medicine, Rheumatology Research Unit, University Federico II, 80138 Naples, Italy.
Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy.
J Clin Med. 2020 Sep 27;9(10):3127. doi: 10.3390/jcm9103127.
This observational and prospective study evaluated the clinical correlations of sonographic lesions in consecutive psoriatic arthritis (PsA) dactylitis cases. Eighty-three dactylitic digits were evaluated clinically and sonographically before treatment and at one-month (T1) and three-month (T3) follow-up. Clinical evaluation included the Leeds Dactylitis Index-basic (LDI-b) score and the visual analogue scales for pain (VAS-p) and functional impairment (VAS-FI). High-frequency ultrasound with grey scale (GS) and power Doppler (PD) assessed flexor tenosynovitis (FT), soft tissue oedema (STO), extensor tendon paratenonitis, and joint synovitis. There was a statistically significant correlation between the clinical parameters (VAS-p, VAS-FI, and LDI-b) and FT and STO at T1 and T3. We found statistically significant improvement in FT and STO for the cases with clinically meaningful treatment responses ( < 0.001). After a multiple conditional logistic regression analysis, the only variables that correlated with a T1 clinical response were the resolutions of PD FT (OR 15.66) and PD STO (OR 6.23), while the resolution of PD FT (OR 27.77) and of GS STO (OR 7.29) correlated with a T3 clinical response. The clinical improvements of active dactylitis are linked to the regression of sonographic evidence of extracapsular inflammation (particularly FT and STO).
这项观察性前瞻性研究评估了连续性银屑病关节炎（PsA）指炎病例中超声病变的临床相关性。在治疗前以及随访1个月（T1）和3个月（T3）时，对83个患指进行了临床和超声评估。临床评估包括利兹指炎指数基础版（LDI-b）评分以及疼痛视觉模拟量表（VAS-p）和功能障碍视觉模拟量表（VAS-FI）。采用灰阶（GS）和能量多普勒（PD）的高频超声评估屈肌腱腱鞘炎（FT）、软组织水肿（STO）、伸肌腱周围炎和关节滑膜炎。在T1和T3时，临床参数（VAS-p、VAS-FI和LDI-b）与FT和STO之间存在统计学显著相关性。对于具有临床意义治疗反应的病例，我们发现FT和STO有统计学显著改善（<0.001）。经过多因素条件逻辑回归分析，与T1临床反应相关的唯一变量是PD FT的消退（OR 15.66）和PD STO的消退（OR 6.23），而PD FT的消退（OR 27.77）和GS STO的消退（OR 7.29）与T3临床反应相关。活动性指炎的临床改善与关节外炎症超声证据（特别是FT和STO）的消退有关。
