Power Doppler ultrasonographic evaluation of enthesitis in psoriatic arthritis. A multi-center study

Iagnocco, Annamaria; Spadaro, Antonio; Marchesoni, Antonio; Cauli, Alberto; Lucia, Orazio De; Gabba, Alessandra; Takanen, Silvia; Montepaone, Monica; Perrotta, Fabio Massimo; D’Agostino, Maria; Mathieu, Alessandro; Valesini, Guido

doi:10.1016/j.jbspin.2011.10.005

Cited by 30 publications

(14 citation statements)

References 7 publications

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“…However, the value of US findings at the enthesis is not investigated fully. Although Doppler sign at the enthesis is found more frequently in patients with PsA, as compared to healthy controls 10 , it can also be seen in patients with rheumatoid arthritis 11 . Bone changes such as enthesophytes and erosions may also be found as degenerative changes in weight-bearing entheses 12 .…”

Section: Assessment Of Enthesitis In Patients With Psoriatic Arthritimentioning

confidence: 96%

Assessment of enthesitis in patients with psoriatic arthritis using clinical examination and ultrasound

Kristensen

Christensen

Schmidt

et al. 2016

MLTJ

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SummaryBackground: Enthesitis is a major feature of psoriatic arthritis. However, clinical assessment of enthesitis is known to lack accuracy and have poor interobserver reliability. Objective: To determine effect of training on clinical assessment of enthesitis and to compare ultrasonography with clinical examination for the detection of entheseal abnormalities. Methods: 20 rheumatologists performed repeated assessment of enthesitis in patients with established psoriatic arthritis before and after a 2-hour training session in standardised enthesitis count according to Leeds 5 . LEI has been developed for measuring enthesitis in patients with PsA 6 . However, all the scoring systems are known to have limitations in terms of reliability, validity, and sensitivity 3 . Another limitation of clinical enthesitis count is the specificity of the finding of tenderness in these areas. Many of the entheseal points are relatively near to joints and accepted tender points for fibromyalgia, raising the possibility of misclassification. Imaging modalities such as ultrasound (US) have been investigated to determine whether they improve entheseal disease assessment. Studies have shown that US indices for enthesitis are more sensitive than clinical examination 7,8 . The OMERACT US Specialist Interest Group has achieved agreement on US definition of enthesitis and its elementary components to ensure a higher degree of homogeneity and comparability of results between studies and in daily clinical work 9 . However, the value of US findings at the enthesis is not investigated fully. Although Doppler sign at the enthesis is found more frequently in patients with PsA, as compared to healthy controls 10 , it can also be seen in patients with rheumatoid arthritis 11 . Bone changes such as enthesophytes and erosions may also be found as degenerative changes in weight-bearing entheses 12 . Furthermore, the application of US in daily practice in patients with PsA is limited by the time required to examine multiple sites of enthesitis. Since clinical enthesitis is a hallmark feature of PsA, there is a need for improvement of clinical assessment of enthesitis and evaluation of the benefits of US as an outcome measure in daily practice. The aim of this study was to examine if training in standardised assessment of enthesitis according to LEI and SPARCC is able to improve interobserver variation in patients with established PsA. Furthermore, we aimed to compare US and clinical assessment of enthesitis to determine the added value of US in enthesitis assessment. Methods SubjectsOutpatients with PsA according to Classification Criteria for Psoriatic Arthritis (CASPAR criteria) were enrolled from the Departments of Rheumatology, Aalborg University Hospital, Denmark, during routine presentation to the clinic. The inclusion criteria were established PsA requiring systemic treatment with disease modifying anti-rheumatic drugs. Exclusion criteria were treatment with biological drugs or treatment with oral corticosteroids. All patients taking NSAID...

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Section: Assessment Of Enthesitis In Patients With Psoriatic Arthritimentioning

confidence: 96%

Assessment of enthesitis in patients with psoriatic arthritis using clinical examination and ultrasound

Kristensen

Christensen

Schmidt

et al. 2016

MLTJ

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“…МРТ всего тела в качестве наиболее частой патологии при ПА находит энтезит (у 66 % пациентов -в районе бедра). При ис-пользовании доплерографии сигнал от энтезита нижних конечностей был зафиксирован у 40,2 % больных ПА в одном исследовании [39], но в другом исследовании был признан редким (4,6 %) [70]. К тому же энтезит сравним с поражениями при СА и обнаруживается у пациентов с рецидивирующим острым передним увеитом, особенно у больных с положительным HLA-B27.…”

Section: медиальный эпикондилит 17unclassified

Enthesitis and Psoriatic Onychopathy as a Factor for Prediction of Psoriatic Arthritis in Psoriasis

Сидорчик

Линев

Радзыня

et al. 2018

Vestnik dermatologii i venerologii

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Psoriatic arthritis is a psoriasis-related spondyloarthropathy that occurs in 20–30 % of patients with psoriasis. Psoriatic arthritis affects the patient’s quality of life indicators and are more often associated with disabilities of working age than psoriasis skin form. Nail psoriasis has been proposed as a predictor for the development of psoriatic arthritis. The inflammation involving the entheses, called enthesitis, is an early inflammatory change seen in psoriatic arthritis, and nail changes appear to result from the close relationship between the nail and the enthesis of the distal interphalangeal extensor tendon, one of the main entheseal compartments affected in psoriatic arthritis. Various imaging studies have demonstrated that there is a considerable proportion of undiagnosed psoriatic arthritis among patients with psoriasis. Since early detection and treatment of psoriatic arthritis could, ultimately, allow the prevention of clinical and radiologic progression of the disease, there is the need to establish clinical indicators to detect this risk.

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“…Doppler activity in grayscale enthesitis changes has been reported to be frequent in patients with SpA, and also specifically in PsA, as compared with patients with mechanical low back pain and healthy controls, 43,44 but Doppler findings in entheses may also be seen in RA patients, although with less severity and frequency. 45 Subclinical enthesitis is also present in PsA, and US may aid in the classification of the patients as having oligoarthritis or multiple joint involvement. 42 …”

Section: Enthesitismentioning

confidence: 99%

Imaging in Psoriatic Arthritis

Poggenborg

Østergaard

2015

Rheumatic Disease Clinics of North America

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Power Doppler ultrasonographic evaluation of enthesitis in psoriatic arthritis. A multi-center study

Abstract: [No abstract available

Cited by 30 publications

References 7 publications

Assessment of enthesitis in patients with psoriatic arthritis using clinical examination and ultrasound

Assessment of enthesitis in patients with psoriatic arthritis using clinical examination and ultrasound

Enthesitis and Psoriatic Onychopathy as a Factor for Prediction of Psoriatic Arthritis in Psoriasis

Imaging in Psoriatic Arthritis

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