Chen Rongfen, Zhong Xiaoyuan, Huang Dawei, Chen Zitong, Yu Yingyuan, Lu Jiajing, Wang Qiao, Kong Luyang, Yi Xuemei, Zhao Yujing, Ding Yangfeng, Guo Lehang, Shi Yuling
Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China.
Institute of Psoriasis, Tongji University School of Medicine, Shanghai, 200443, China.
Heliyon. 2024 Jul 4;10(13):e34136. doi: 10.1016/j.heliyon.2024.e34136. eCollection 2024 Jul 15.
Psoriatic arthritis (PsA) is an immune-mediated form of chronic inflammatory arthritis associated with psoriasis (PsO). It constitutes a significant comorbidity of PsO and is distinguished by the presence of widespread musculoskeletal inflammation.
The aim of this study is to precisely detect asymptomatic PsA using ultrasound (US) examinations and to distinguish between various stages of PsO.
All patients with moderate-to-severe PsO, who consented to undergo musculoskeletal US examinations during their hospitalization between September 2020 and January 2022, were enrolled in the study. We compared patients' demographic characteristics, comorbidities, disease duration, relevant laboratory parameters, and musculoskeletal US findings.
A total of 547 patients with PsO were included in the study, and 114 of them received a diagnosis of PsA. Furthermore, 16.45 % of patients with moderate to severe PsO displayed subclinical PsA. We observed a significantly higher frequency of abnormal US findings in patients with PsA compared to those without PsA, with a sensitivity of 95.61 % and a specificity of 79.22 %. Additionally, the incidence of enthesitis and synovitis varied significantly between PsA and non-PsA patients, and they were identified as independent variables predicting the presence of PsA. Furthermore, the interphalangeal joint, knee joint, and calcaneal tendon were the most frequently affected areas in PsA, as indicated by the observed US changes.
Ultrasound examination proves to be a valuable tool for detecting subclinical PsA, facilitating early screening of the condition. Particular attention should be directed towards changes in the interphalangeal joint, knee joint, and calcaneal tendon when reviewing ultrasound images of asymptomatic patients.
银屑病关节炎（PsA）是一种与银屑病（PsO）相关的免疫介导的慢性炎症性关节炎。它是PsO的一种重要合并症，其特征是存在广泛的肌肉骨骼炎症。
本研究的目的是使用超声（US）检查精确检测无症状的PsA，并区分PsO的不同阶段。
所有在2020年9月至2022年1月住院期间同意接受肌肉骨骼超声检查的中度至重度PsO患者均纳入本研究。我们比较了患者的人口统计学特征、合并症、病程、相关实验室参数和肌肉骨骼超声检查结果。
本研究共纳入547例PsO患者，其中114例被诊断为PsA。此外，16.45%的中度至重度PsO患者表现为亚临床PsA。我们观察到，与无PsA的患者相比，PsA患者超声检查异常结果的频率显著更高，敏感性为95.61%，特异性为79.22%。此外，PsA患者和非PsA患者的附着点炎和滑膜炎发生率差异显著，它们被确定为预测PsA存在的独立变量。此外，根据观察到的超声变化，指间关节、膝关节和跟腱是PsA中最常受累的部位。
超声检查被证明是检测亚临床PsA的有价值工具，有助于对该疾病进行早期筛查。在查看无症状患者的超声图像时，应特别关注指间关节、膝关节和跟腱的变化。
