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Which ultrasound lesions contribute to dactylitis in psoriatic arthritis and their reliability in a clinical setting

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@article{9fdbf75d99394a4aa00f3f6df2c3556b,
title = "Which ultrasound lesions contribute to dactylitis in psoriatic arthritis and their reliability in a clinical setting",
abstract = "OBJECTIVES: To explore the frequency of ultrasound elementary lesions in dactylitis in psoriatic arthritis (PsA), and the reliability of scoring these lesions in a clinical setting.METHODS: In 31 patients with PsA and clinical dactylitis, ultrasound assessment of the affected finger or toe was performed using greyscale and color Doppler mode. One examiner scanned all patients and a second examiner scanned 10 patients for inter-reader reliability. For each digit, the following lesions were evaluated: subcutaneous edema; soft tissue thickening; synovitis of the digital joints; tenosynovitis of the flexor tendon; enthesitis at the deep flexor tendon and the extensor tendon entheses; and paratenonitis of the extensor tendon. A dactylitis sum-score was calculated. Findings in clinically tender and non-tender digits were compared.RESULTS: The most frequent lesions were soft tissue thickening (81%) and subcutaneous edema (74%) followed by synovitis (56-68%) and flexor tenosynovitis (52%). Color Doppler was most frequently found subcutaneously (55%) and around the flexor tendons (45%). All lesions were typically found in combinations, most commonly subcutaneous edema and synovitis (71%), subcutaneous edema and flexor tenosynovitis (52%), and all three in combination (52%). Tender digits had a higher dactylitis sum-score and numerically higher prevalence of most lesions than non-tender digits. Intra- and inter-reader agreements were moderate to excellent, though lower for few components of digital enthesitis, especially hypoechogenicity.CONCLUSION: Dactylitis in PsA appears to encompass several lesions, most often subcutaneous changes combined with synovitis and/or flexor tenosynovitis. Reliability of scoring established ultrasound lesions of dactylitis in a clinical setting is moderate-excellent. Key Points • Dactylitis in psoriatic arthritis consists of multiple ultrasound lesions • A dactylitis ultrasound sum-score gives an impression of severity by including all lesions • Reliability of ultrasound scoring of dactylitis components is good.",
author = "Felbo, {Sara K} and Mikkel {\O}stergaard and S{\o}rensen, {Inge J} and Lene Terslev",
note = "COPECARE",
year = "2021",
month = mar,
doi = "10.1007/s10067-020-05483-9",
language = "English",
volume = "40",
pages = "1061--1067",
journal = "Clinical Rheumatology",
issn = "0770-3198",
publisher = "Springer U K",
number = "3",

}

RIS

TY - JOUR

T1 - Which ultrasound lesions contribute to dactylitis in psoriatic arthritis and their reliability in a clinical setting

AU - Felbo, Sara K

AU - Østergaard, Mikkel

AU - Sørensen, Inge J

AU - Terslev, Lene

N1 - COPECARE

PY - 2021/3

Y1 - 2021/3

N2 - OBJECTIVES: To explore the frequency of ultrasound elementary lesions in dactylitis in psoriatic arthritis (PsA), and the reliability of scoring these lesions in a clinical setting.METHODS: In 31 patients with PsA and clinical dactylitis, ultrasound assessment of the affected finger or toe was performed using greyscale and color Doppler mode. One examiner scanned all patients and a second examiner scanned 10 patients for inter-reader reliability. For each digit, the following lesions were evaluated: subcutaneous edema; soft tissue thickening; synovitis of the digital joints; tenosynovitis of the flexor tendon; enthesitis at the deep flexor tendon and the extensor tendon entheses; and paratenonitis of the extensor tendon. A dactylitis sum-score was calculated. Findings in clinically tender and non-tender digits were compared.RESULTS: The most frequent lesions were soft tissue thickening (81%) and subcutaneous edema (74%) followed by synovitis (56-68%) and flexor tenosynovitis (52%). Color Doppler was most frequently found subcutaneously (55%) and around the flexor tendons (45%). All lesions were typically found in combinations, most commonly subcutaneous edema and synovitis (71%), subcutaneous edema and flexor tenosynovitis (52%), and all three in combination (52%). Tender digits had a higher dactylitis sum-score and numerically higher prevalence of most lesions than non-tender digits. Intra- and inter-reader agreements were moderate to excellent, though lower for few components of digital enthesitis, especially hypoechogenicity.CONCLUSION: Dactylitis in PsA appears to encompass several lesions, most often subcutaneous changes combined with synovitis and/or flexor tenosynovitis. Reliability of scoring established ultrasound lesions of dactylitis in a clinical setting is moderate-excellent. Key Points • Dactylitis in psoriatic arthritis consists of multiple ultrasound lesions • A dactylitis ultrasound sum-score gives an impression of severity by including all lesions • Reliability of ultrasound scoring of dactylitis components is good.

AB - OBJECTIVES: To explore the frequency of ultrasound elementary lesions in dactylitis in psoriatic arthritis (PsA), and the reliability of scoring these lesions in a clinical setting.METHODS: In 31 patients with PsA and clinical dactylitis, ultrasound assessment of the affected finger or toe was performed using greyscale and color Doppler mode. One examiner scanned all patients and a second examiner scanned 10 patients for inter-reader reliability. For each digit, the following lesions were evaluated: subcutaneous edema; soft tissue thickening; synovitis of the digital joints; tenosynovitis of the flexor tendon; enthesitis at the deep flexor tendon and the extensor tendon entheses; and paratenonitis of the extensor tendon. A dactylitis sum-score was calculated. Findings in clinically tender and non-tender digits were compared.RESULTS: The most frequent lesions were soft tissue thickening (81%) and subcutaneous edema (74%) followed by synovitis (56-68%) and flexor tenosynovitis (52%). Color Doppler was most frequently found subcutaneously (55%) and around the flexor tendons (45%). All lesions were typically found in combinations, most commonly subcutaneous edema and synovitis (71%), subcutaneous edema and flexor tenosynovitis (52%), and all three in combination (52%). Tender digits had a higher dactylitis sum-score and numerically higher prevalence of most lesions than non-tender digits. Intra- and inter-reader agreements were moderate to excellent, though lower for few components of digital enthesitis, especially hypoechogenicity.CONCLUSION: Dactylitis in PsA appears to encompass several lesions, most often subcutaneous changes combined with synovitis and/or flexor tenosynovitis. Reliability of scoring established ultrasound lesions of dactylitis in a clinical setting is moderate-excellent. Key Points • Dactylitis in psoriatic arthritis consists of multiple ultrasound lesions • A dactylitis ultrasound sum-score gives an impression of severity by including all lesions • Reliability of ultrasound scoring of dactylitis components is good.

U2 - 10.1007/s10067-020-05483-9

DO - 10.1007/s10067-020-05483-9

M3 - Journal article

C2 - 33155158

VL - 40

SP - 1061

EP - 1067

JO - Clinical Rheumatology

JF - Clinical Rheumatology

SN - 0770-3198

IS - 3

ER -

ID: 61639630