Document Detail

Early psoriatic arthritis: the clinical spectrum.
MedLine Citation:
PMID:  18050372     Owner:  NLM     Status:  MEDLINE    
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.
Raffaele Scarpa; Alberto Cuocolo; Rosario Peluso; Mariangela Atteno; Pietro Gisonni; Salvatore Iervolino; Matteo Nicola Dario Di Minno; Emanuele Nicolai; Marco Salvatore; Antonio del Puente
Publication Detail:
Type:  Journal Article     Date:  2007-11-15
Journal Detail:
Title:  The Journal of rheumatology     Volume:  35     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-07     Completed Date:  2008-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  137-41     Citation Subset:  IM    
Department of Clinical and Experimental Medicine, Early Psoriatic Arthritis Clinic, Rheumatology Research Unit, University Federico II, Naples, Italy.
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MeSH Terms
Arthritis, Psoriatic / physiopathology*,  radionuclide imaging*,  ultrasonography
Cohort Studies
Disease Progression
Joint Diseases / radionuclide imaging*,  ultrasonography
Radionuclide Imaging
Severity of Illness Index
Comment In:
J Rheumatol. 2008 Jan;35(1):3-5   [PMID:  18176985 ]

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