RT Journal Article
SR Electronic
T1 Association of physical activity and medication with enthesitis on ultrasound in psoriatic arthritis
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.180782
DO 10.3899/jrheum.180782
A1 Kim Wervers
A1 Irene Herrings
A1 Jolanda J.  Luime
A1 Ilja Tchetverikov
A1 Andreas H.  Gerards
A1 Johanna M.W.  Hazes
A1 Marijn Vis
YR 2019
UL http://www.jrheum.org/content/early/2019/02/25/jrheum.180782.abstract
AB Objective Enthesitis is a manifestation of psoriatic arthritis (PsA), but its symptoms are difficult to interpret clinically. We investigated the associations of ultrasonographic changes in entheses with clinical characteristics in PsA patients, and compared enthesis changes of PsA patients aged 35 to 60 with healthy volunteers of that age. Methods Consecutive PsA patients participated in this cross-sectional study, irrespective of enthesitis complaints and age. We collected data about complaints, physical activity and activity avoidance, medication and clinical enthesitis. Inflammatory and structural enthesis changes were scored with the modified MAdrid Sonographic Enthesitis Index (MASEI). Among all PsA patients, associations between ultrasound scores and clinical characteristics were investigated using linear regression. We compared ultrasound scores of healthy volunteers and PsA patients aged 35-60 years using Wilcoxon rank tests. Results Eighty-four PsA patients and 25 healthy volunteers participated. In PsA patients, we found a small association between higher inflammatory modified MASEI score and higher age (β:0.07, 95% CI:0-0.13) and current use of biologicals (β:1.56 95% CI 0.16-2.95). Patients reporting avoiding activities had significantly lower inflammatory modified MASEI scores (β:-1.71, 95% CI:-3.1;-0.32) than those who did not. The PsA patients aged 35-60 (n=50) had similar inflammatory scores as healthy volunteers but higher structural scores (median 6 vs. 2, p=0.01). Conclusion Within PsA patients, avoiding physical activity, younger age and not using biologicals was associated with less entheses inflammation. PsA patients and healthy volunteers aged 35 to 60 years displayed similar levels of inflammatory changes of the entheses, but PsA patients had more structural damage.