Büttner Juliane, Glimm Anne-Marie, Kokolakis Georgios, Erdmann-Keding Magdalena, Burmester Gerd-Rüdiger, Hoff Paula, Klotsche Jens, Ohrndorf Sarah
Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Endocrinology, Nephrology and Rheumatology, Universitätsklinikum Leipzig, Leipzig, Germany.
Front Med (Lausanne). 2022 Mar 18;9:845545. doi: 10.3389/fmed.2022.845545. eCollection 2022.
Early diagnosis of psoriatic arthritis (PsA) is crucial for a patient outcome but hampered by heterogenous manifestation and a lack of specific biomarkers. We recently showed that fluorescence optical imaging (FOI) can differentiate between patients with confirmed and suspected PsA. This study aims to follow-up (FU) patients with confirmed and suspected PsA focusing on patients with a change from suspected to confirmed PsA by the use of FOI in comparison with musculoskeletal ultrasound (MSUS).
Follow-up examination of patients included in the study performed by Erdmann-Keding et al. in which FOI of both hands was performed in a standardized manner using three predefined phases (p1-p3) and PrimaVista Mode (PVM). The comparison was drawn to grayscale-power Doppler (GS/PD) MSUS of the clinically dominant hand (wrist, MCP, PIP, DIP 2-5) from dorsal or palmar.
Patients with a change from suspected to diagnosed PsA showed an increased prevalence of joints with pathological enhancement in FOI ( = 0.046) with an unchanged joint distribution pattern, especially with a dominant involvement of DIP joints. Compared to the baseline, these patients were three times more common to show enhancement in FOI p3 at FU. Newly detected pathologic joints by FOI (PVM, p2) and MSUS at FU were positively associated with the change of diagnosis from suspected to confirmed PsA (FOI: AUC 0.78; GSUS: AUC 0.77).
Fluorescence optical imaging appears to be a helpful tool to detect early PsA and to distinguish between acute and chronic disease stages. It could thereby become a suitable tool as a screening method to select psoriasis patients with an indication for further rheumatological evaluation.
银屑病关节炎（PsA）的早期诊断对患者预后至关重要，但因临床表现异质性和缺乏特异性生物标志物而受到阻碍。我们最近发现，荧光光学成像（FOI）可区分确诊和疑似PsA患者。本研究旨在对确诊和疑似PsA患者进行随访（FU），重点关注通过FOI从疑似转变为确诊PsA的患者，并与肌肉骨骼超声（MSUS）进行比较。
对Erdmann-Keding等人研究中纳入的患者进行随访检查，其中双手的FOI采用三个预定义阶段（p1-p3）和PrimaVista模式（PVM）以标准化方式进行。将其与临床优势手（腕关节、掌指关节、近端指间关节、第2-5指远端指间关节）从背侧或掌侧进行的灰阶-能量多普勒（GS/PD）MSUS进行比较。
从疑似转变为确诊PsA的患者在FOI中病理性增强的关节患病率增加（ = 0.046），关节分布模式不变，尤其是远端指间关节受累为主。与基线相比，这些患者在随访时FOI p3中出现增强的情况是基线时的三倍。随访时通过FOI（PVM，p2）和MSUS新检测到的病理性关节与从疑似到确诊PsA的诊断变化呈正相关（FOI：AUC 0.78；GSUS：AUC 0.77）。
荧光光学成像似乎是检测早期PsA以及区分急性和慢性疾病阶段的有用工具。因此，它可能成为一种合适的筛查方法，用于选择有进一步风湿病评估指征的银屑病患者。
