Department of Clinical Immunology & Rheumatology, Christian Medical College, Vellore, India.
Department of Radiology, Christian Medical College, Vellore, India.
Int J Rheum Dis. 2021 Dec;24(12):1467-1472. doi: 10.1111/1756-185X.14156. Epub 2021 Jun 28.
This study aimed to compare inflammation at the interphalangeal (IP) joint of thumb in patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA), undifferentiated inflammatory arthritis (UIA), and in psoriasis patients without clinical arthritis (PsO) using low-field magnetic resonance imaging (MRI).
Age-matched and disease duration-matched patients with inflammatory arthritis (RA, PsA, and UIA) and psoriasis patients without clinical arthritis (PsO), who had undergone MRI of hands were included in this study. The presence or absence of MRI inflammatory lesions including synovitis, tenosynovitis, and bone marrow edema was assessed by three independent readers. Agreement between the readers was assessed using the intraclass correlation coefficient. Risk ratio of MRI global inflammation around thumb IP joints among patients with PsA was compared with the other groups.
Clinical parameters and MRI inflammation were studied in 161 patients (42 PsA, 28 RA, 29 UIA, and 62 PsO). Global MRI inflammation at the IP joint of the thumb was observed in 33.3% of PsA patients compared with 14.3% in RA, and 10.3% in UIA. Subclinical MRI inflammation was observed in 8.1% of patients with PsO. The risk ratios of MRI global inflammation at the IP joint of the thumb in PsA patients were 2.3 (95% confidence interval [CI] 0.86-6.36) and 3.2 (95% CI 1.02-10.21) compared with RA and UIA patients, respectively.
Global MRI inflammation around the IP joint of the thumb is significantly more common in patients with PsA as compared to individuals with UIA.
本研究旨在使用低场磁共振成像（MRI）比较患有银屑病关节炎（PsA）、类风湿关节炎（RA）、未分化炎性关节炎（UIA）和无临床关节炎的银屑病患者（PsO）的指间关节（IP）炎症。
本研究纳入了年龄匹配和疾病持续时间匹配的炎性关节炎（RA、PsA 和 UIA）患者和无临床关节炎的银屑病患者（PsO），这些患者均接受了手部 MRI 检查。由三位独立的读者评估 MRI 炎症病变（滑膜炎、腱鞘炎和骨髓水肿）的存在或不存在。通过组内相关系数评估读者间的一致性。比较 PsA 患者拇指 IP 关节周围 MRI 整体炎症的风险比与其他组。
研究共纳入 161 名患者（42 名 PsA、28 名 RA、29 名 UIA 和 62 名 PsO）的临床参数和 MRI 炎症情况。与 RA（14.3%）和 UIA（10.3%）相比，33.3%的 PsA 患者出现拇指 IP 关节的整体 MRI 炎症，观察到亚临床 MRI 炎症。与 RA 和 UIA 患者相比，PsA 患者拇指 IP 关节的 MRI 整体炎症的风险比分别为 2.3（95%置信区间 [CI] 0.86-6.36）和 3.2（95% CI 1.02-10.21）。
与 UIA 患者相比，PsA 患者拇指 IP 关节的整体 MRI 炎症更为常见。
