Improving Imaging Modalities in Early Psoriatic Arthritis: The Role of Ultrasound in Early Diagnosis of Psoriatic Arthritis.
Authors
Gudu, Tania
Ng, Beverly
Jethwa, Hannah
Graham, Catherine
Kudva, Veda
Rammanohar, Jashmitha
Zhang, Chen
Sapsford, Mark
Jadon, Deepak R
Publication Date
2021Journal Title
Front Med (Lausanne)
ISSN
2296-858X
Publisher
Frontiers Media SA
Volume
8
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Gudu, T., Ng, B., Jethwa, H., Graham, C., Kudva, V., Rammanohar, J., Zhang, C., et al. (2021). Improving Imaging Modalities in Early Psoriatic Arthritis: The Role of Ultrasound in Early Diagnosis of Psoriatic Arthritis.. Front Med (Lausanne), 8 https://doi.org/10.3389/fmed.2021.804695
Abstract
Objective: Despite recent advances, early diagnosis of psoriatic arthritis (PsA) remains a challenge in clinical practice. Ultrasound (US) could be a useful tool for the diagnosis and management of PsA. The objective of this review was to determine the role of US in early diagnosis of PsA. Methods: We have performed a literature review aiming to evaluate studies on US findings in psoriasis and their predictive value of progression to PsA, as well as studies on US features specific for PsA in comparison with other conditions. Results: A total of 40 studies were included. Sixteen studies assessed US findings in psoriasis, of which only 3 prospectively evaluated the role of US in predicting progression to PsA. Patients with PsA had a greater frequency of US abnormalities, in particular enthesitis and Power Doppler(PD) signal compared to patients with psoriasis only. In the longitudinal studies, psoriatic patients with higher enthesopathy scores at baseline were more likely to progress to PsA. Twenty-four studies evaluated US abnormalities in PsA and compared them to other conditions. Most specific US features that distinguish PsA from psoriasis were PD signal and erosions in joints and entheses. Extra-synovial changes, including peri-tendinous dermal soft tissue oedema with associated PD signal and flexor tendon enthesopathy, as well as thickening of the pulleys in the flexor tendons were highly characteristic for PsA, as they were frequently found in PsA patients, but in none of the RA patients. US-detected entheseal abnormalities in particular erosions and PD signal were more frequent in patients with PsA compared to fibromyalgia. Conclusion: Despite the wide use of US in PsA, more research is needed to identify predictive factors of progression to PsA in patients with psoriasis, as well as to determine most specific US features that differentiate PsA from other conditions.
Keywords
Medicine, psoriatic arthritis, ultrasound, early diagnosis, differential diagnosis, psoriasis, enthesitis
Identifiers
External DOI: https://doi.org/10.3389/fmed.2021.804695
This record's URL: https://www.repository.cam.ac.uk/handle/1810/333215
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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