The association between sonographic enthesitis and radiographic damage in psoriatic arthritis

Abstract

BackgroundTo examine the association between sonographic enthesitis and the severity of radiographic features of damage in the peripheral and axial joints in psoriatic arthritis (PsA).MethodsA cross-sectional analysis was conducted in patients with PsA. The MAdrid Sonography Enthesitis Index (MASEI) scoring system was used to quantify the extent of sonographic entheseal abnormalities. Radiographic damage in the peripheral joints and spine was assessed by the modified Steinbrocker score (mSS), Modified New York Criteria for sacroiliitis, and the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). The association between MASEI and the extent of radiographic damage was assessed using negative binomial and logistic regression. The results were expressed in terms of the regression coefficient estimates and their exponentiated values (eβ) or odds ratios (OR), and 95% confidence intervals (CI).ResultsTwo hundred and twenty three patients were analyzed; 58% were males, with mean ± SD age of 55.9 ± 12.9 years and PsA duration of 16.7 ± 12.4 years. Regression analyses yielded an association between higher MASEI scores (10 units increase) and peripheral joint damage including mSS (eβ = 1.42, 95% CI: 1.15, 1.72), joint ankylosis (OR = 1.93, 95% CI: 1.37, 2.72), arthritis mutilans (OR = 1.77, 95% CI: 1.23, 2.54), and periostitis (OR = 1.41, 95% CI: 1.08, 1.84). Similarly, an association was found between higher MASEI scores and axial damage as measured by mSASSS (eβ = 2.18, 95% CI: 1.16, 4.09) and sacroiliitis (OR = 1.33, 95% CI: 1.03, 1.72).ConclusionsThe severity of sonographic enthesitis is a potential marker of radiographic peripheral and axial joint damage in PsA.

Augmented Th17 Differentiation Leads to Cutaneous and Synovio‐Entheseal Inflammation in a Novel Model of Psoriatic Arthritis

“…This leads to underappreciation of the early phases of the disease and a concomitant suboptimal treatment during the timeframe of active inflammation, whereas current therapies could potentially alter the natural history of this process. Indeed, several groups have stressed the role of the entheses as an initiating site of inflammation in a proportion of PsA patients who go on to develop synovitis and destructive arthritis (23,(40)(41)(42). However, very little is known about the biology and molecular mechanisms by which proinflammatory resident cells can drive downstream systemic effects.…”

The Association Between HLA Genetic Susceptibility Markers and Sonographic Enthesitis in Psoriatic Arthritis

“…They proposed that while the initial trigger of enthesitis may be mechanical microtrauma which can occur in HLA-B*27-negative individuals, in HLA-B*27-positive subjects the inflammatory response is perpetuated and becomes chronic, involving the bone and the adjacent fibrocartilage (33). Consistent with this hypothesis, a recent crosssectional study demonstrated that enthesitis is a marker for worse outcome in patients with PsA, by showing an association between sonographic enthesitis and the extent of peripheral and axial radiographic damage (34).…”

Röntgendiagnostik in der Rheumatologie im Jahr 2020

“…Weiterführend ist die PsA durch eine Enthesitis gekennzeichnet. Diese kann im Röntgen nicht sicher erfasst werden, wobei das Auftreten der Enthesitis mit dem radiologischen Schweregrad der PsA korreliert [25]. Zur Beurteilung der knöchernen Veränderungen einer PsA im Bereich der kleinen Vorfuß-und Handgelenke wird ebenfalls standardmäßig das Röntgen eingesetzt [26].…”