ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1379

Ultrasonographic Is More Sensitive Than Traditional Clinical Evaluation in the Detection of Hands and Wrists Synovitis and Digital Soft Tissue Involvement in Early Psoriatic Arthritis

Francesca Bandinelli1, Valentina Denaro1, Francesca Prignano2, Diletta Bonciani2, Ledio Collaku3 and Marco Matucci-Cerinic4, 1Department of Internal Medicine, Division of Rheumatology, University of Florence, Florence, Italy, 2Dermatology, University of Florence, Florence, Italy, 3Internal Medicine, University of Tirana, Tirana, Albania, 4Department of Biomedicine & Division of Rheumatology AOUC, University of Florence, Florence, Italy

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Background: Clinical measures are widely used in established psoriatic arthritis (PsA) but in early phase of disease, often fail to identify the joint and tendons involvement.

Purpose: To investigate the ultrasonography (US) abnormalities in hands and wrists of early PsA patients and to compare them with clinical evaluation

Methods:

We performed a retrospective study on 112 early PsA (onset of inflammatory symptoms lower than one year) in the period 2008-2010, diagnosed with CASPAR criteria (1).

Data were carried out by the analysis of medical records of all patients, completed of demographic data, historical information, clinical (swollen joints and dactylitis count) and MyLab70 Xview (linear probe 15 MHz and PFR 1 Mhz) and US (Power doppler [PD] positive synovitis, erosions, tenosynovitis and PD in soft tissue around flexor finger tendons) hands and wrists assessment.

Results:

Out of 224 wrists and 1120 MCP, 1120 PIP and 1120 DIP  totally observed, synovitis was more frequently found on wrist (50/224; 22,3%) and US resulted more sensitive than clinical evaluation (swollen joints): in wrists 50/224 (22,3%) vs 42/224 (18,7%), in MCP 28/1220 (2,5%) vs 11/1120 (1%), in IPP 24/1120 (2,1%) vs 15/1120 (1,3%), in IPD 3/1120 (0,3%) vs 1/1120 (0,09%). Also erosions were present only in MCP (mostly II e III MCP) in 10/1120 joints (0,9%). At US, PD signal in soft tissue around tendons (68/1120, 6,1%) was more frequent than tenosynovitis of flexors (29/1120, 2,6%) and were both found also in patients without clinical dactilitis (55/68 PD [80,8] of soft tissue and 18/29 [62%] of tenosynovitis).

Conclusion:

US showed more frequently synovitis of wrists but also erosions and PD signals in soft tissue are present in early phase of PsA. In all cases, US seemed more sensitive than clinical evaluation for synovitis and dactilytis.

References:

1.  Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H; CASPAR Study Group. Classification criteria for psoriatic arthritis: development of new  criteria from a large international study. Arthritis Rheum. 2006 Aug;54(8):2665-73.

Disclosure:

F. Bandinelli,
None;

V. Denaro,
None;

F. Prignano,
None;

D. Bonciani,
None;

L. Collaku,
None;

M. Matucci-Cerinic,
None.

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