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Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Assessment of enthesitis in patients with psoriatic arthritis using clinical examination and ultrasound.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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BACKGROUND:

Enthesitis is a major feature of psoriatic arthritis. However, clinical assessment of enthesitis is known to lack accuracy and have poor interobserver reliability.
OBJECTIVE:

To determine effect of training on clinical assessment of enthesitis and to compare ultrasonography with clinical examination for the detection of entheseal abnormalities.
METHODS:

20 rheumatologists performed repeated assessment of enthesitis in patients with established psoriatic arthritis before and after a 2-hour training session in standardised enthesitis count according to Leeds Enthesitis Index (LEI) and Spondyloarthritis Research Consortium of Canada Enthesitis Index (SPARCC). Moreover, 20 patients underwent clinical and ultrasonographic examination of entheses to evaluate consensus-based elementary lesions of enthesitis.
RESULTS:

Training significantly increased Intra-class Correlation Coefficient for LEI from 0.18 to 0.82 and for SPARCC from 0.38 to 0.67. Ultrasound examination showed high associations between hypoechogenicity and increased thickness of the entheses and clinical examination. There was no correlation between erosions and enthesophytes found by ultrasound and clinical assessments.
CONCLUSION:

Training in standardised enthesitis scoring systems significantly improved clinical assessments of enthesitis and should be performed before use in daily clinical practice. Ultrasound revealed more advanced stages of enthesitis, such as enthesophytes and erosions, which were not detected with clinical examination.
OriginalsprogEngelsk
TidsskriftMuscles, Ligaments and Tendons Journal
Vol/bind6
Udgave nummer2
Sider (fra-til)241
Antal sider246
ISSN2240-4554
DOI
StatusUdgivet - sep. 2016

ID: 49633716