PT  - JOURNAL ARTICLE
AU  - Nicolò Girolimetto
AU  - Pierluigi Macchioni
AU  - Ilaria Tinazzi
AU  - Luisa Costa
AU  - Dennis McGonagle
AU  - Rosario Peluso
AU  - Antonio Del Puente
AU  - Olga Addimanda
AU  - Antonio Marchetta
AU  - Niccolò Possemato
AU  - Marco Tasso
AU  - Carlo Salvarani
AU  - Raffaele Scarpa
AU  - Francesco Caso
TI  - Ultrasonographic evidence of predominance of acute extracapsular and chronic intrasynovial patterns in 100 psoriatic hand dactylitis.
AID  - 10.3899/jrheum.190046
DP  - 2019 May 15
TA  - The Journal of Rheumatology
PG  - jrheum.190046
4099  - http://www.jrheum.org/content/early/2019/05/13/jrheum.190046.short
4100  - http://www.jrheum.org/content/early/2019/05/13/jrheum.190046.full
AB  - Objective To use ultrasonography to explore whether the duration of psoriatic dactylitis was associated with different patterns of extracapsular and synovial based involvement. Methods One hundred cases of hand dactylitis from 85 psoriatic arthritis (PsA) patients were consecutively enrolled in a multicentre cross-sectional study and divided into two groups according to dactylitis duration (shorter or longer than the median: 20 weeks). All dactylitis fingers were investigated using high frequency ultrasound (US) both in grey scale (GS) and Power Doppler (PD), evaluating the presence of flexor tenosynovitis, soft tissue oedema, subcutaneous PD signal (PDS), extensor tendon involvement and joints synovitis. Results Cases with a shorter dactylitis duration (<20 weeks) had a significantly higher prevalence of GS flexor tenosynovitis of grade > 2, PD flexor tenosynovitis, soft tissue oedema and subcutaneous PDS (p = 0.001, p < 0.001, p < 0.05 and p = 0.001, respectively). However, the presence of synovitis in GS and PD mode (in both cases at proximal interphalangeal level) was more frequent in patients with the longer dactylitis duration (p < 0.001). When detected in the chronic form flexor tenosynovitis was grade 2 or less. Conclusion In a large cohort of PsA hand dactylitis, we found a predominant extracapsular inflammation (flexor tenosynovitis and soft tissue oedema) in early cases and a high prevalence of joint synovitis at PIP level in the chronic form. However, longitudinal imaging studies are need for clarifying these aspects.