RT Journal Article
SR Electronic
T1 Ultrasound and Magnetic Resonance Imaging in the Evaluation of Psoriatic Dactylitis: Status and Perspectives
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1951
OP 1957
DO 10.3899/jrheum.130643
VO 40
IS 12
A1 Catherine J. Bakewell
A1 Ignazio Olivieri
A1 Sibel Z. Aydin
A1 Christian Dejaco
A1 Kei Ikeda
A1 Marwin Gutierrez
A1 Lene Terslev
A1 Ralf Thiele
A1 Maria Antionetta D’Agostino
A1 Gurjit S. Kaeley
YR 2013
UL http://www.jrheum.org/content/40/12/1951.abstract
AB Objective. Dactylitis, a characteristic feature of the spondyloarthropathies, occurs in up to 48% of patients with psoriatic arthritis (PsA). No clear consensus on the underlying components and pathogenesis of dactylitis exists in the literature. We undertook a systematic review of ultrasound (US) and magnetic resonance imaging (MRI) literature to better define imaging elements that contribute to the dactylitic digit seen in PsA. Our objectives were to determine first the level of homogeneity of each imaging modality’s definition of the components of dactylitis, and second, to evaluate the metric properties of each imaging modality according to the Outcome Measures in Rheumatology Clinical Trials (OMERACT) filter. Methods. Searches were performed in PUBMED and EMBASE for articles pertaining to MRI, US, and dactylitis. Data regarding the reported features of dactylitis were collected and categorized, and the metrological qualities of the studies were assessed. Results. The most commonly described features of dactylitis were flexor tendon tenosynovitis and joint synovitis (90%). Extratendinous soft tissue thickening and extensor tendonitis were described nearly equally as being present and absent. Discrepancy exists as to whether entheses proper contribute to the etiology of dactylitis. An increasing number of studies categorize abnormalities in several tissue compartments including the soft tissue, tendon sheaths, and joints, as well as ligaments. Conclusion. The understanding of which tissues contribute to dactylitic inflammation has evolved. However, there is a lack of literature regarding the natural history of these abnormalities. This systematic review provides guidance in defining elementary lesions that may discriminate dactylitic digits from normal digits, leading to development of a composite measure of activity and severity of dactylitis.