Abstract：
OBJECTIVE: To identify patients in the subclinical psoriatic arthritis (Sub-PsA) phase by ultrasound (US) and provide a solution to screen them.
METHODS: A total of 490 participants with moderate-to-severe psoriasis were evaluated. Among them, 384 participants without arthritis symptoms were enrolled into the silent psoriasis group and 106 participants with arthritis symptoms, called prodromal/active PsA phase, were enrolled into the clinical PsA group. Another 80 non-psoriasis participants were enrolled into the control group. Each participant received clinical assessments and US examinations of 60 joints, 38 tendons, and 40 entheses. We compared the incidences of synovio-enthesitis, synovitis, tenosynovitis, erosion, and dactylitis detected on US among the three groups. Subsequently, on the basis of significant US findings, we distinguished Sub-PsA from psoriasis alone (PsO) in the silent psoriasis group and analyzed the clinical characteristics, mainly including basic clinical characteristics, body surface area (BSA), and Psoriasis Area and Severity Index (PASI) score.
RESULTS: Only synovio-enthesitis significantly differed between the control group and the silent psoriasis group (1.3% vs. 16.1%, p < 0.001). The knee was the most commonly involved site of synovio-enthesitis (79.0%). Taking synovio-enthesitis as the standard, 16.1% of silent psoriasis participants and 12.7% of all psoriasis participants were in the Sub-PsA phase. Furthermore, there were no differences in BSA and PASI among the three phases of PsO, Sub-PsA, and prodromal/active PsA.
CONCLUSIONS: Since the psoriasis patients in Sub-PsA phase was as high as 12.7% in all patients with moderate-to-severe psoriasis, US-detected synovio-enthesitis was recommended routinely for screening them regardless of arthritis symptoms, especially in the lower limbs.
CONCLUSIONS: • Synovio-enthesitis on ultrasound was significantly associated with subclinical psoriatic arthritis, especially in the lower limbs. • Routine ultrasound evaluation could help screen psoriasis patients in the subclinical psoriatic arthritis phase, which was as high as 12.7% in all psoriasis patients.
METHODS: A total of 490 participants with moderate-to-severe psoriasis were evaluated. Among them, 384 participants without arthritis symptoms were enrolled into the silent psoriasis group and 106 participants with arthritis symptoms, called prodromal/active PsA phase, were enrolled into the clinical PsA group. Another 80 non-psoriasis participants were enrolled into the control group. Each participant received clinical assessments and US examinations of 60 joints, 38 tendons, and 40 entheses. We compared the incidences of synovio-enthesitis, synovitis, tenosynovitis, erosion, and dactylitis detected on US among the three groups. Subsequently, on the basis of significant US findings, we distinguished Sub-PsA from psoriasis alone (PsO) in the silent psoriasis group and analyzed the clinical characteristics, mainly including basic clinical characteristics, body surface area (BSA), and Psoriasis Area and Severity Index (PASI) score.
RESULTS: Only synovio-enthesitis significantly differed between the control group and the silent psoriasis group (1.3% vs. 16.1%, p < 0.001). The knee was the most commonly involved site of synovio-enthesitis (79.0%). Taking synovio-enthesitis as the standard, 16.1% of silent psoriasis participants and 12.7% of all psoriasis participants were in the Sub-PsA phase. Furthermore, there were no differences in BSA and PASI among the three phases of PsO, Sub-PsA, and prodromal/active PsA.
CONCLUSIONS: Since the psoriasis patients in Sub-PsA phase was as high as 12.7% in all patients with moderate-to-severe psoriasis, US-detected synovio-enthesitis was recommended routinely for screening them regardless of arthritis symptoms, especially in the lower limbs.
CONCLUSIONS: • Synovio-enthesitis on ultrasound was significantly associated with subclinical psoriatic arthritis, especially in the lower limbs. • Routine ultrasound evaluation could help screen psoriasis patients in the subclinical psoriatic arthritis phase, which was as high as 12.7% in all psoriasis patients.
摘要：
目的：通过超声（US）识别处于亚临床型银屑病关节炎（Sub-PsA）阶段的患者，并提供筛查的解决方案。
方法：对490名中度至重度银屑病患者进行了评估。其中,384名没有关节炎症状的参与者被纳入无症状牛皮癣组，106名有关节炎症状的参与者，称为前驱/活跃PsA阶段，纳入临床PsA组。另外80名非银屑病参与者被纳入对照组。每位参与者接受了60个关节的临床评估和美国检查，38根肌腱,和40个论文。我们比较了滑膜附件炎的发生率，滑膜炎,腱鞘炎,侵蚀,在三组中，在US上检测到牙龈炎。随后，根据美国的重大发现，我们在无症状银屑病组中区分了Sub-PsA和单纯银屑病（PsO），并分析了其临床特征，主要包括基本临床特征，体表面积（BSA），和银屑病面积和严重程度指数（PASI）评分。
结果：只有滑膜附件炎在对照组和无症状性银屑病组之间有显著差异(1.3%vs.16.1%,p<0.001)。膝关节是滑膜附件炎最常见的部位（79.0％）。以滑膜附件炎为标准，16.1%的无症状银屑病参与者和12.7%的所有银屑病参与者处于Sub-PsA阶段。此外，在PsO的三个阶段中，BSA和PASI没有差异，Sub-PsA,和前驱/活性PsA。
结论：由于在所有中度至重度银屑病患者中，亚PsA期银屑病患者高达12.7%，无论关节炎症状如何，美国检测到的滑膜附件炎通常被推荐用于筛查。尤其是下肢.
结论：•超声检查的滑膜附件炎与亚临床型银屑病关节炎显著相关，尤其是下肢.•常规超声评估可以帮助筛查亚临床银屑病关节炎期的银屑病患者，在所有银屑病患者中高达12.7%。
方法：对490名中度至重度银屑病患者进行了评估。
结果：只有滑膜附件炎在对照组和无症状性银屑病组之间有显著差异(1.3%vs.
结论：由于在所有中度至重度银屑病患者中，亚PsA期银屑病患者高达12.7%，
结论：•超声检查的滑膜附件炎与亚临床型银屑病关节炎显著相关，
