Olivas-Vergara Otto, Martínez-Estupiñán Lina, Romero-Bueno Fredeswinda, Sánchez-Pernaute Olga, Godo Javier R, Fariña-Sabaris María Del Carmen, Ruffin-Vicente Belén, Criado-Alcazar Agustina, Borges Pablo E, Recuero-Díaz Sheila, Alvear-Torres Andrea, Gil Amalia, García-Fernández Antía, Hoyo-Fernández Ana Elena, Ortega-Trompeta M Belén, Sánchez-Barba-Izquierdo M Isabel, Herrero-Beaumont Gabriel, Largo Raquel, Naredo Esperanza
Department of Rheumatology and Joint and Bone Research Unit. Fundación Jiménez Díaz University Hospital and Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), Autonomous University of Madrid, Madrid, Spain.
Department of Dermatology. Fundación Jiménez Díaz University Hospital and Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), Autonomous University of Madrid, Madrid, Spain.
Semin Arthritis Rheum. 2025 Feb;70:152612. doi: 10.1016/j.semarthrit.2024.152612. Epub 2024 Dec 19.
The primary objective of this prospective, longitudinal, observational, single-centre study was to evaluate the association between ultrasound-assessed lesions of dactylitis and the diagnosis of psoriatic arthritis (PsA) in patients with psoriasis (PsO) and hand arthralgia.
We included adult patients diagnosed with PsO with hand arthralgia, with or without other musculoskeletal complaints. They were clinically assessed at baseline, 6 and 12 months by a rheumatologist blinded to the ultrasound findings. At baseline, patients underwent a B-mode (BM) and power Doppler (PD) ultrasound assessment by other rheumatologist blinded to clinical data. The ultrasound evaluation included bilateral detection and scoring of synovitis (3 joints, 0-3), tenosynovitis (flexor tendons, 0-3), enthesitis (9 sites, 0-1), peri‑extensor tendon inflammation (PETI) (0-3), and subcutaneous tissue inflammation (SCTI) (0-3) in the 2nd-5th fingers.
Seventy patients [44 women; mean (SD) age 51 (12.4) years] were included, of whom 64 completed the study. Of these, 15 (23.4 %) were diagnosed with PsA during the 12-month follow-up period. At finger level, the presence and amount of baseline BM and PD synovitis, BM tenosynovitis, BM and PD enthesitis, and BM and PD PETI were associated with PsA diagnosis (p < .05). A predictive model including two variables, presence of PD synovitis and BM enthesitis, was found to predict PsA diagnosis (χ2 = 35.38; p < .001) with an accuracy of 89.1 %, a sensitivity of 86.7 % and a specificity of 89.8 %.
Ultrasound-assessed lesions of dactylitis were associated with a diagnosis of PsA and the short-term development of PsA in patients with PsO and hand arthralgia.
这项前瞻性、纵向、观察性单中心研究的主要目的是评估超声评估的指（趾）炎病变与银屑病（PsO）合并手部关节痛患者银屑病关节炎（PsA）诊断之间的关联。
我们纳入了诊断为PsO且有手部关节痛的成年患者，无论有无其他肌肉骨骼症状。由对超声检查结果不知情的风湿病学家在基线、6个月和12个月时对他们进行临床评估。在基线时，由对临床数据不知情的其他风湿病学家对患者进行B超（BM）和能量多普勒（PD）超声评估。超声评估包括对第2至第5指的滑膜炎（3个关节，0 - 3分）、腱鞘炎（屈肌腱，0 - 3分）、附着点炎（9个部位，0 - 1分）、伸肌腱周围炎症（PETI）（0 - 3分）和皮下组织炎症（SCTI）（0 - 3分）进行双侧检测和评分。
共纳入70例患者[44例女性；平均（标准差）年龄51（12.4）岁]，其中64例完成了研究。在这些患者中，15例（23.4%）在12个月的随访期内被诊断为PsA。在手指水平，基线时BM和PD滑膜炎、BM腱鞘炎、BM和PD附着点炎以及BM和PD PETI的存在及程度与PsA诊断相关（p < 0.05）。发现一个包含两个变量的预测模型，即PD滑膜炎和BM附着点炎的存在，可预测PsA诊断（χ2 = 35.38；p < 0.001），准确率为89.1%，敏感性为86.7%，特异性为89.8%。
超声评估的指（趾）炎病变与PsO合并手部关节痛患者的PsA诊断及PsA的短期发展相关。
