Bosch Philipp, Lackner Angelika, Dreo Barbara, Husic Rusmir, Ficjan Anja, Gretler Judith, Graninger Winfried, Duftner Christina, Hermann Josef, Dejaco Christian
Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria.
Department of Internal Medicine VI, Medical University Innsbruck, Innsbruck, Austria.
Rheumatology (Oxford). 2022 Apr 18;61(SI):SI92-SI96. doi: 10.1093/rheumatology/keab764.
To evaluate tender joints (TJ) and swollen joints (SJ) for the assessment of ultrasound (US) defined inflammation in PsA.
Eighty-three PsA patients underwent clinical and US examinations at two scheduled study visits 12 months apart. Tenderness and swelling were assessed at 68 and 66 joints, respectively, and US examinations were conducted at all 68 joints. At patient level, associations with clinical composites and US scores were performed using correlations and by analysing patients with predominantly tender (pTender) or swollen joints (pSwollen). At joint level, a Power Doppler (PD) value ≥ 1 was defined as active synovitis. A generalized linear mixed model was created to assess the predictive value of TJ and SJ for active synovitis after 12 months.
SJC showed better correlations with GS/PD scores (r = 0.37/0.47) than with TJC (PD: r = 0.33), while TJC correlated better with patient reported outcomes (PROMs) like patient global assessment (TJC: r = 0.57; SJC r = 0.39). Patients with pTender showed poorer results for PROMs and disease activity scores than patients with pSwollen, but not for laboratory or US markers of inflammation. Swollen joints showed active synovitis in 35% of cases, while only 16% of tender joints were active according to US. Swelling at baseline better predicted active synovitis at the same joint after 12 months [odds ratio (OR) 6.33, P <0.001] as compared with tenderness (OR 3.58, P <0.001).
SJ are more closely linked with US signs of inflammation as compared with TJ in PsA. Joint swelling is a better predictor for signs of US inflammation than tenderness after one year of follow-up.
评估压痛关节（TJ）和肿胀关节（SJ），以用于银屑病关节炎（PsA）中超声（US）定义的炎症评估。
83例PsA患者在间隔12个月的两次预定研究访视时接受了临床和超声检查。分别在68个和66个关节处评估压痛和肿胀情况，并对所有68个关节进行超声检查。在患者层面，通过相关性分析以及分析以压痛为主（pTender）或肿胀为主（pSwollen）的患者，来研究与临床综合指标和超声评分的相关性。在关节层面，将功率多普勒（PD）值≥1定义为活动性滑膜炎。建立广义线性混合模型，以评估12个月后TJ和SJ对活动性滑膜炎的预测价值。
与压痛关节计数（TJC）相比，肿胀关节计数（SJC）与灰阶/功率多普勒（GS/PD）评分的相关性更好（r = 0.37/0.47），而TJC与患者报告结局（PROMs）如患者整体评估的相关性更好（TJC：r = 0.
