Ultrasound assessment of enthesis thickness in psoriasis and psoriatic arthritis: A cross-sectional study

Graceffa, Dario; Bonifati, C.; Lora, Viviana; Saraceni, Pier Luigi; Felice, Catia De; Chimenti, Maria Sole; Perricone, Roberto; Morrone, Andrea

doi:10.4103/ijdvl.ijdvl_205_17

Cited by 10 publications

(6 citation statements)

References 1 publication

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“…While many studies have investigated and emphasized enthesis of the lower extremities, our study of the patellar tendon were significantly higher in patients with PsO than in HCs 29 . Graceffa et al showed also the thickness of the triceps tendon in PsA patients higher than PsO patients and HCs but they did not find any significant differences between PsO patients and HCs 29 . Zuliani et al reported that enthesitis is mostly observed in the proximal patellar tendon, and the most common lesion is increase in enthesis thickness 14 .…”

Section: Discussionmentioning

confidence: 52%

“…Huang et al, reported a modest correlation between GUESS and Brown University Nail Enthesis Scale scores in the PsA group 28 . In contrast, Graceffa et al reported a correlation between enthesis thickness and BMI 29 . Furthermore, Moshrif et al concluded that a positive correlation exists between enthesitis and age, disease duration, BMI, and hyperuricemia 29 .…”

Section: Discussionmentioning

confidence: 87%

“…In contrast, Graceffa et al reported a correlation between enthesis thickness and BMI 29 . Furthermore, Moshrif et al concluded that a positive correlation exists between enthesitis and age, disease duration, BMI, and hyperuricemia 29 . We did not find any correlation between sex and MASEI score.…”

Section: Discussionmentioning

confidence: 87%

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Detection of subclinical enthesitis by ultrasonography in patients with psoriasis and controls

Karamanlioglu,

Ozkan,

Emel Ceren Arıkan

et al. 2024

ARP Rheumatol

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Introduction: Psoriasis is a widespread chronic inflammatory skin disease; enthesitis is inflammation of the tendon, ligament, and joint capsule insertion, prevalent in patients with psoriatic arthritis. Objectives: The aim of study to evaluate the utility of the Madrid Sonography Enthesitis Index scoring system for accurate detection of subclinical enthesitis in patients with Psoriasis compared with healthy controls. Another objective was to assess increase in enthesis area and Psoriatic arthritis incidence, in a prospective 1-year follow-up. Method: Patients aged ≥18 years who were diagnosed with Psoriasis, without musculoskeletal complaints, and who did not have any clinical sign and/or symptom of enthesitis and synovitis were included in the study. The patients and healthy controls were evaluated with ultrasonography. Ultrasonography evaluation consisted of the detection of gray-scale enthesitis and power Doppler signal in the enthesis areas. The Madrid Sonography Enthesitis Index scoring system was used to quantify the extent of the sonographic enthesis abnormalities. Results: The mean MASEI score, structure, thickness, erosion, and calcification were significantly higher in the Psoriasis group than in the control group. The mean MASEI score, structure, erosion, and calcification measurements were significantly higher at the last examination when compared to the first examination. The triceps was the most commonly affected tendon in both groups. Conclusion: Ultrasonography is an important tool for diagnosis and follow-up of subclinical enthesitis in patients with psoriasis. Regardless of disease duration and severity, patients should be screened using ultrasonography at yearly intervals.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 87%

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Detection of subclinical enthesitis by ultrasonography in patients with psoriasis and controls

Karamanlioglu,

Ozkan,

Emel Ceren Arıkan

et al. 2024

ARP Rheumatol

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“…Most studies showed that US changes, both inflammatory and structural, are more frequent in patients with PsA compared with psoriasis only (15,24,25,27,30,32). However, as stated above, subclinical US inflammatory changes are quite common in patients with psoriasis without PsA (9-16, 18, 20).…”

Section: Psoriatic Arthritis Vs Psoriasismentioning

confidence: 98%

“…Ten studies evaluating the differences of US findings in PsA vs. psoriasis were identified in this review (15,(24)(25)(26)(27)(28)(29)(30)(31)(32). Enthesis was the most frequently evaluated anatomical structure by US (6 out of 10 studies).…”

Section: Psoriatic Arthritis Vs Psoriasismentioning

confidence: 99%

Improving Imaging Modalities in Early Psoriatic Arthritis: The Role of Ultrasound in Early Diagnosis of Psoriatic Arthritis

Gudu

Jethwa

et al. 2022

Front. Med.

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Objective: Despite recent advances, early diagnosis of psoriatic arthritis (PsA) remains a challenge in clinical practice. Ultrasound (US) could be a useful tool for the diagnosis and management of PsA. The objective of this review was to determine the role of US in early diagnosis of PsA.Methods: We have performed a literature review aiming to evaluate studies on US findings in psoriasis and their predictive value of progression to PsA, as well as studies on US features specific for PsA in comparison with other conditions.Results: A total of 40 studies were included. Sixteen studies assessed US findings in psoriasis, of which only 3 prospectively evaluated the role of US in predicting progression to PsA. Patients with PsA had a greater frequency of US abnormalities, in particular enthesitis and Power Doppler(PD) signal compared to patients with psoriasis only. In the longitudinal studies, psoriatic patients with higher enthesopathy scores at baseline were more likely to progress to PsA. Twenty-four studies evaluated US abnormalities in PsA and compared them to other conditions. Most specific US features that distinguish PsA from psoriasis were PD signal and erosions in joints and entheses. Extra-synovial changes, including peri-tendinous dermal soft tissue oedema with associated PD signal and flexor tendon enthesopathy, as well as thickening of the pulleys in the flexor tendons were highly characteristic for PsA, as they were frequently found in PsA patients, but in none of the RA patients. US-detected entheseal abnormalities in particular erosions and PD signal were more frequent in patients with PsA compared to fibromyalgia.Conclusion: Despite the wide use of US in PsA, more research is needed to identify predictive factors of progression to PsA in patients with psoriasis, as well as to determine most specific US features that differentiate PsA from other conditions.

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High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis

et al. 2020

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Background: To evaluate the value of 3 Tesla (T) magnetic resonance imaging (MRI) changes of flexor tendon pulleys for the differentiation of psoriatic (PsA) and rheumatoid arthritis (RA), using a novel 16-channel highresolution hand coil. Methods: Seventeen patients with active PsA, 20 patients with active RA, and 16 healthy controls (HC) underwent high-resolution 3 T MRI using the dedicated 16-channel hand coil. Images were analyzed by three independent readers for the degree of inflammatory changes, thickness of flexor tendon pulleys, and comparison to the outcome measures for RA clinical trials (OMERACT) PsA MRI score (PsAMRIS) and to its sub-scores. For correlation analyses, Spearman rho correlation was calculated. Results: Flexor tendon pulleys were thicker in PsA than in RA patients (mean difference 0.16 mm, p < 0.001) and HC (mean difference 0.2 mm, p < 0.001) and showed a higher degree of associated inflammatory changes (mean difference from RA 4.7, p = 0.048; mean difference from HC 14.65, p < 0.001). Additionally, there was a strong correlation of accessory pulley inflammation and PsAMRIS and its acute-inflammatory sub-scores, flexor tenosynovitis, synovitis, and periarticular inflammation (for the second digit synovitis ρ = 0.72, flexor tenosynovitis ρ = 0.7, overall PsAMRIS ρ = 0.72, p < 0.01). Similar robust correlations were evident in digits 3-5. Weaker correlations were evident in RA (synovitis ρ = 0.49, flexor tenosynovitis ρ = 0.49, periarticular inflammation ρ = 0.4). Conclusion: The assessment of MRI changes of flexor tendon pulleys is potentially beneficial for disease detection in PsA, as well as for its distinction from RA and HC.

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Ultrasound assessment of enthesis thickness in psoriasis and psoriatic arthritis: A cross-sectional study

Cited by 10 publications

References 1 publication

Detection of subclinical enthesitis by ultrasonography in patients with psoriasis and controls

Detection of subclinical enthesitis by ultrasonography in patients with psoriasis and controls

Improving Imaging Modalities in Early Psoriatic Arthritis: The Role of Ultrasound in Early Diagnosis of Psoriatic Arthritis

High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis

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