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Research ArticlePsoriatic Arthritis

Ultrasonographic Evidence of Predominance of Acute Extracapsular and Chronic Intrasynovial Patterns in 100 Cases of Psoriatic Hand Dactylitis

Nicolò Girolimetto, Pierluigi Macchioni, Ilaria Tinazzi, Luisa Costa, Dennis McGonagle, Rosario Peluso, Antonio Del Puente, Olga Addimanda, Antonio Marchetta, Niccolò Possemato, Marco Tasso, Carlo Salvarani, Raffaele Scarpa and Francesco Caso
The Journal of Rheumatology February 2020, 47 (2) 227-233; DOI: https://doi.org/10.3899/jrheum.190046
Nicolò Girolimetto
From the Department of Clinical Medicine and Surgery, Rheumatology Research Unit, University Federico II, Naples; Department of Rheumatology, Azienda USL–Institute for Research and Health Care (IRCCS) di Reggio Emilia, Reggio Emilia; Unit of Rheumatology, Ospedale Sacro Cuore, Negrar, Verona, Italy; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK; Rheumatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy.
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Pierluigi Macchioni
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Ilaria Tinazzi
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Luisa Costa
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Dennis McGonagle
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Rosario Peluso
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Antonio Del Puente
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Olga Addimanda
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Antonio Marchetta
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Niccolò Possemato
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Marco Tasso
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Carlo Salvarani
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Raffaele Scarpa
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  • For correspondence: rscarpa@unina.it
Francesco Caso
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Abstract

Objective. To use ultrasonography to study 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 patients with psoriatic arthritis (PsA) were consecutively enrolled in a multicenter cross-sectional study and divided into 2 groups according to dactylitis duration (shorter or longer than the median: 20 weeks). All dactylitis fingers were investigated using high-frequency ultrasound both in greyscale (GS) and power Doppler (PD), evaluating the presence of flexor tenosynovitis, soft tissue edema, subcutaneous PD signal (PDS), extensor tendon involvement, and joint 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 edema, 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 longer dactylitis duration (p < 0.001). When detected in the chronic form, flexor tenosynovitis was grade 2 or lower.

Conclusion. In a large cohort of PsA hand dactylitis, we found a predominant extracapsular inflammation (flexor tenosynovitis and soft tissue edema) in early cases and a high prevalence of joint synovitis at proximal interphalangeal level in the chronic form. However, longitudinal imaging studies are needed to clarify these aspects.

Key Indexing Terms:
  • DACTYLITIS
  • ULTRASOUND
  • PSORIATIC ARTHRITIS
  • TENOSYNOVITIS
  • EDEMA
  • FLEXOR TENDON
  • Accepted for publication April 24, 2019.
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1 Feb 2020
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Ultrasonographic Evidence of Predominance of Acute Extracapsular and Chronic Intrasynovial Patterns in 100 Cases of Psoriatic Hand Dactylitis
Nicolò Girolimetto, Pierluigi Macchioni, Ilaria Tinazzi, Luisa Costa, Dennis McGonagle, Rosario Peluso, Antonio Del Puente, Olga Addimanda, Antonio Marchetta, Niccolò Possemato, Marco Tasso, Carlo Salvarani, Raffaele Scarpa, Francesco Caso
The Journal of Rheumatology Feb 2020, 47 (2) 227-233; DOI: 10.3899/jrheum.190046

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Ultrasonographic Evidence of Predominance of Acute Extracapsular and Chronic Intrasynovial Patterns in 100 Cases of Psoriatic Hand Dactylitis
Nicolò Girolimetto, Pierluigi Macchioni, Ilaria Tinazzi, Luisa Costa, Dennis McGonagle, Rosario Peluso, Antonio Del Puente, Olga Addimanda, Antonio Marchetta, Niccolò Possemato, Marco Tasso, Carlo Salvarani, Raffaele Scarpa, Francesco Caso
The Journal of Rheumatology Feb 2020, 47 (2) 227-233; DOI: 10.3899/jrheum.190046
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Keywords

DACTYLITIS
ULTRASOUND
PSORIATIC ARTHRITIS
TENOSYNOVITIS
EDEMA
FLEXOR TENDON

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Keywords

  • DACTYLITIS
  • ultrasound
  • psoriatic arthritis
  • TENOSYNOVITIS
  • EDEMA
  • FLEXOR TENDON

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