Power Doppler Ultrasound Abnormalities Evaluated in Psoriatic Arthritis

Patients with psoriatic arthritis (PsA) have high percentages of peripheral joint, tendon, enthesis, and bursa involvement, according to data published in The Journal of Rheumatology. Data also show that young and middle-aged individuals with psoriasis without clinical signs of arthritis have high percentages of synovitis and enthesitis, as well as elevated power Doppler signal grades of synovitis, enthesitis, and tenosynovitis, which may indicate the clinical onset of PsA in these age groups.

A clinical cross-sectional study was conducted at West China Hospital of Sichuan University in Chengdu, Sichuan, China, between January 2014 and June 2016 to evaluate the prevalence rates of peripheral joint, enthesis, tendon, and bursa abnormalities using power Doppler ultrasound examination in patients with PsA, patients with psoriasis without signs of arthritis (non-PsA psoriasis), and healthy individuals.

A total of 86 patients with PsA, 242 patients with non-PsA psoriasis, and 253 healthy participants were evaluated with the use of 2-dimensional ultrasound and power Doppler ultrasound. Peripheral joint, enthesis, tendon, and bursa abnormalities were explored, which characterized abnormal power Doppler. Sites with abnormalities in various age groups were compared among the 3 groups of participants. Researchers also compared power Doppler signal grades for the abnormalities.

In patients with PsA, significantly higher percentages of sites demonstrating joint effusion or synovitis, enthesitis, and tenosynovitis among all age groups (P <.01 for all) were reported compared with patients with non-PsA psoriasis and healthy individuals. Moreover, significantly higher rates of sites with bursitis were observed among young and middle-aged groups of patients with PsA, compared with the non-PsA and control groups (P <.01 for all).

Among participants with non-PsA psoriasis, significantly higher rates of joint effusion or synovitis and enthesitis sites, as well as elevated power Doppler single grades of synovitis, enthesitis, and tenosynovitis, were reported compared with the control group, in both young and middle-aged groups (P <.01 for all).

The investigators concluded that based on the findings of this study, regular ultrasound examination among patients with PsA is critical. In addition, more attention should be focused on young and middle-aged patients with psoriasis without clinical signs of arthritis.

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Reference

Tang Y, Yang Y, Xiang X, Wang L, Zhang L, Qiu L. Power Doppler ultrasound evaluation of peripheral joint, entheses, tendon, and bursa abnormalities in psoriatic patients: a clinical study [published online April 15, 2018].  J Rheumatol. doi: 10.3899/jrheum.170765