| Early psoriatic arthritis: the clinical spectrum. | |
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MedLine Citation:
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PMID: 18050372 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article Date: 2007-11-15 |
Journal Detail:
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Title: The Journal of rheumatology Volume: 35 ISSN: 0315-162X ISO Abbreviation: J. Rheumatol. Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-01-07 Completed Date: 2008-03-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7501984 Medline TA: J Rheumatol Country: Canada |
Other Details:
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Languages: eng Pagination: 137-41 Citation Subset: IM |
Affiliation:
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Department of Clinical and Experimental Medicine, Early Psoriatic Arthritis Clinic, Rheumatology Research Unit, University Federico II, Naples, Italy. rscarpa@unina.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Arthritis, Psoriatic / physiopathology*, radionuclide imaging*, ultrasonography Cohort Studies Disease Progression Female Humans Joint Diseases / radionuclide imaging*, ultrasonography Male Radionuclide Imaging Severity of Illness Index |
| Comments/Corrections | |
Comment In:
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J Rheumatol. 2008 Jan;35(1):3-5
[PMID:
18176985
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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