Rheumatology, University of Ottawa Faculty of Medicine, Ottawa, and The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Rheumatology Unit, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
Clin Exp Rheumatol. 2022 Jan;40(1):44-48. doi: 10.55563/clinexprheumatol/frrq75. Epub 2021 Jan 11.
The aim of this study is to explore the link between the severity of the joint and entheses involvement in psoriatic arthritis (PsA) using musculoskeletal ultrasound (US).
PsA patients from two centres in the Psoriatic Arthritis International Database (PsArt-ID) (n=126) underwent an ultrasound assessment of 46 joints and 12 large entheses. The correlation between joint and enthesitis scores on the US was analysed, in addition to the clinical indices versus the US.
Grey-scale (GS) synovitis score for the joints was moderately correlated with the total enthesitis score (r=0.410, p<0.001). The Global Outcome Measure in Rheumatology in Clinical Trials-European League Against Rheumatism Synovitis Score (GLOESS) score was also found in correlation with the total enthesitis score (r=0.400, p<0.001). The link between the US and clinical examination findings only showed a poor correlation between swollen joint counts (SJC) and joint-US scores (r=0.298, p=0.001 for GLOESS). Assessment of the entheses on US showed a poor-moderate correlation between the entheseal damage scores and tender joint counts (TJC) (r=0.217, p=0.018) and SJC (r=0.326, p<0.001). In terms of the clinical examination and activity parameters, none of the clinical parameters and acute phase reactants were correlated to Leeds Enthesitis Index.
Our study showed a link between the severity of the sonographic findings in the joints and the entheses. Imaging using US to assess enthesitis in clinical trials may improve our understanding on the role of enthesitis in disease pathogenesis.
本研究旨在通过肌肉骨骼超声（US）探讨银屑病关节炎（PsA）关节和肌腱附着处受累严重程度之间的关系。
来自两个 Psoriatic Arthritis International Database（PsArt-ID）中心的 126 例 PsA 患者接受了 46 个关节和 12 个大肌腱附着处的超声评估。分析了关节和肌腱附着处 US 评分之间的相关性，以及临床指标与 US 之间的相关性。
关节的灰阶（GS）滑膜炎评分与总肌腱附着处评分中度相关（r=0.410，p<0.001）。Global Outcome Measure in Rheumatology in Clinical Trials-European League Against Rheumatism Synovitis Score（GLOESS）评分也与总肌腱附着处评分相关（r=0.400，p<0.001）。US 与临床检查结果之间的联系仅显示肿胀关节计数（SJC）与关节-US 评分之间的相关性较差（r=0.298，p=0.001，GLOESS）。US 评估肌腱附着处显示肌腱附着处损伤评分与压痛关节计数（TJC）（r=0.217，p=0.018）和 SJC（r=0.326，p<0.001）之间存在较差到中度相关性。在临床检查和活动参数方面，没有任何临床参数和急性期反应物与 Leeds 肌腱附着处指数相关。
我们的研究表明，关节和肌腱附着处超声发现的严重程度之间存在联系。在临床试验中使用 US 评估肌腱附着处炎可能有助于我们更好地了解肌腱附着处炎在疾病发病机制中的作用。
