TY - JOUR T1 - Early psoriatic arthritis: the clinical spectrum. JF - The Journal of Rheumatology JO - J Rheumatol SP - 137 LP - 141 VL - 35 IS - 1 AU - Raffaele Scarpa AU - Alberto Cuocolo AU - Rosario Peluso AU - Mariangela Atteno AU - Pietro Gisonni AU - Salvatore Iervolino AU - Matteo Nicola Dario Di Minno AU - Emanuele Nicolai AU - Marco Salvatore AU - Antonio del Puente Y1 - 2008/01/01 UR - http://www.jrheum.org/content/35/1/137.abstract N2 - OBJECTIVE: To characterize the clinical pattern of early psoriatic arthritis (PsA). METHODS: We studied 47 consecutive patients: 29 had definite PsA and 18 had the "sine psoriasis" subset. Inclusion criteria were articular and/or entheseal involvement of < or =12 weeks' duration and the exclusive use, before enrollment, of nonsteroidal antiinflammatory drugs to control articular symptoms. All patients underwent clinical examination, blood tests, total-body bone scintigraphy, articular ultrasonography, and radiography of clinically involved joints and/or entheses. RESULTS: On the basis of clinical examination, early PsA was an oligo-enthesoarthritis in over 75% of patients studied. In contrast, the number of joints and/or entheses showing increased tracer uptake on bone scintigraphy was 3 times greater, compared to the clinical evidence (p < 0.001). Articular ultrasonography confirmed the inflammatory involvement of synovium and/or entheses in all articular sites active at time of bone scintigraphy, but silent at clinical examination. In addition, 7 patients showed the occurrence of joint and/or entheseal erosions on standard radiography. CONCLUSION: Bone scintigraphy yields a more accurate evaluation of entheso-articular involvement and distribution in patients with early PsA. Our results suggest that clinical oligo-enthesoarthritic presentation of early PsA might represent in most cases a polyarticular condition that is at increased risk for clinical progression. These findings have a significant influence on the clinical decision-making process in patients with early PsA. ER -