Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Delta 6 Building, Via dell'Ospedale, PO box 67100, L'Aquila, Italy.
Dermatology Unit, San Salvatore Hospital, L'Aquila, Italy.
Radiol Med. 2022 Dec;127(12):1400-1406. doi: 10.1007/s11547-022-01568-4. Epub 2022 Oct 19.
To characterize nail and enthesis abnormalities using high frequency ultrasound (HFUS) in patients with psoriasis (PSO), psoriatic arthritis (PSA) with PSO, and PSA sine PSO.
Patients with PSO, PSA with PSO, and PSA sine PSO were evaluated and compared in a cross-sectional single centre study. Nail and enthesis abnormalities were evaluated by HFUS using high frequency probes (27 MHz). After a descriptive assessment, Brown University Nail Enthesis Scale (BUNES) and Madrid Sonography Enthesitis Index (MASEI) were used to assess nail and enthesis, respectively.
Fifty-nine patients were enrolled (19 PSO, 22 PSA with PSO, 18 PSA sine PSO). In patients with PSO and in those with PSA and PSO, HFUS evaluation identified the following nail alterations characterised by thickened matrix, inhomogeneous echogenicity of the nail bed, and increased blood flow by power Doppler. In 38.9% patients with PSA sine PSO, a subclinical nail involvement was described. No difference was observed comparing BUNES values in three groups. In PSA patients with PSO and in those with PSA sine PSO, HFUS assessment of entheses mainly showed a hypoechoic aspect and thickness of the tendon, focal cortical erosion, and ossification. A subclinical enthesis involvement in 47.4% patients with PSO was observed. No difference was reported comparing MASEI values in three groups.
Qualitative and quantitative abnormalities of nail and enthesis were demonstrated by HFUS in patients with PSO, PSA with PSO, and PSA sine PSO, suggesting a practical additional tool to be used in clinical settings. Furthermore, HFUS highlighted a subclinical nail involvement in patients with PSA sine PSO and enthesis subclinical alterations in patients with PSO.
使用高频超声（HFUS）对银屑病（PSO）、伴有 PSO 的银屑病关节炎（PSA）和无 PSO 的 PSA 患者的指甲和附着点异常进行特征描述。
在一项横断面单中心研究中，对 PSO、伴有 PSO 的 PSA 和无 PSO 的 PSA 患者进行评估和比较。使用高频探头（27MHz）进行指甲和附着点的 HFUS 评估。在进行描述性评估后，使用布朗大学指甲附着点量表（BUNES）和马德里超声附着点指数（MASEI）分别评估指甲和附着点。
共纳入 59 例患者（19 例 PSO、22 例伴有 PSO 的 PSA、18 例无 PSO 的 PSA）。在 PSO 患者和 PSA 合并 PSO 患者中，HFUS 评估发现了以下指甲改变特征：基质增厚、甲床不均匀回声和彩色多普勒血流增加。在 38.9%的无 PSO 的 PSA 患者中，描述了亚临床指甲受累。三组间 BUNES 值无差异。在伴有 PSO 的 PSA 患者和无 PSO 的 PSA 患者中，HFUS 评估附着点主要表现为低回声表现和肌腱增厚、局灶性皮质侵蚀和骨化。在 47.4%的 PSO 患者中观察到亚临床附着点受累。三组间 MASEI 值无差异。
HFUS 显示 PSO、伴有 PSO 的 PSA 和无 PSO 的 PSA 患者的指甲和附着点存在定性和定量异常，提示这是一种在临床环境中实用的附加工具。此外，HFUS 突出显示了无 PSO 的 PSA 患者存在亚临床指甲受累，以及 PSO 患者存在亚临床附着点改变。
