RT Journal Article
SR Electronic
T1 Ultrasonographic evidence of predominance of acute extracapsular and chronic intrasynovial patterns in 100 psoriatic hand dactylitis.
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.190046
DO 10.3899/jrheum.190046
A1 Nicolò Girolimetto
A1 Pierluigi Macchioni
A1 Ilaria Tinazzi
A1 Luisa Costa
A1 Dennis McGonagle
A1 Rosario Peluso
A1 Antonio Del Puente
A1 Olga Addimanda
A1 Antonio Marchetta
A1 Niccolò Possemato
A1 Marco Tasso
A1 Carlo Salvarani
A1 Raffaele Scarpa
A1 Francesco Caso
YR 2019
UL http://www.jrheum.org/content/early/2019/05/13/jrheum.190046.abstract
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.