PMID- 32301418
OWN - NLM
STAT- MEDLINE
DCOM- 20210210
LR  - 20220923
IS  - 0392-856X (Print)
IS  - 0392-856X (Linking)
VI  - 39
IP  - 1
DP  - 2021 Jan-Feb
TI  - Ultrasound assessment, unlike clinical assessment, reflects enthesitis in 
      patients with psoriatic arthritis.
PG  - 139-145
LID - 10.55563/clinexprheumatol/u8qc6c [doi]
AB  - OBJECTIVES: Enthesitis is a major musculoskeletal manifestation of psoriatic 
      arthritis (PsA). It is conventionally assessed clinically, by the presence of 
      tenderness, despite its low reliability. However, ultrasound (US) provides a 
      sensitive and feasible method for evaluating enthesitis. We investigated 
      enthesitis as assessed clinically and by US in patients with PsA. METHODS: 
      Forty-seven patients with PsA underwent US examination of the bilateral humeral 
      medial epicondyles and insertions of the triceps, distal quadriceps, 
      proximal/distal patellae, Achilles tendons, and plantar fascia. These 14 entheses 
      were also clinically evaluated by tenderness. The correspondence between US and 
      clinical enthesitis was evaluated, as well as their associations with 
      inflammatory markers (C-reactive protein [CRP], matrix metalloproteinase-3 
      [MMP-3]), disease activity indices (Disease Activity in Psoriatic Arthritis 
      [DAPSA], Disease Activity Score 28 joints [DAS28-CRP], Psoriatic Arthritis 
      Screening and Evaluation [PASE], Psoriasis Area Severity Index [PASI]), 
      radiographic damage (modified Total Sharp Score [mTSS]), and functional status 
      (health assessment questionnaire [HAQ]), and axial involvement. RESULTS: Among 47 
      patients with PsA, 37 and 23 had US and clinical enthesitis, respectively. US and 
      clinical enthesitis had very low concordance (kappa coefficient 0.04), with no 
      correlation between enthesitis counts (r=0.15, p=0.30). The US enthesitis count 
      correlated only with the MMP-3 level (r=0.41, p=0.007), whereas the clinical 
      enthesitis count correlated with the DAPSA, DAS28-CRP, HAQ, and PASE (r=0.50, 
      p<0.001; r=0.44, p=0.002; r=0.41, p=0.008; r=0.54, p<0.001, respectively). 
      CONCLUSIONS: US and clinical enthesitis are completely different entities. US 
      enthesitis, but not clinical enthesitis, reflects inflammatory conditions.
FAU - Yamada, Yutaro
AU  - Yamada Y
AD  - Department of Orthopaedic Surgery, Osaka City University Graduate School of 
      Medicine, Osaka, Japan.
FAU - Inui, Kentaro
AU  - Inui K
AD  - Department of Orthopaedic Surgery, Osaka City University Graduate School of 
      Medicine, Osaka, Japan. inuken@med.osaka-cu.ac.jp.
FAU - Okano, Tadashi
AU  - Okano T
AD  - Department of Orthopaedic Surgery, Osaka City University Graduate School of 
      Medicine, Osaka, Japan.
FAU - Mandai, Koji
AU  - Mandai K
AD  - Department of Orthopaedic Surgery, Osaka City University Graduate School of 
      Medicine, Osaka, Japan.
FAU - Mamoto, Kenji
AU  - Mamoto K
AD  - Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan.
FAU - Koike, Tatsuya
AU  - Koike T
AD  - Centre for Senile Degenerative Disorders (CSDD), Osaka City University Graduate 
      School of Medicine, Osaka, Japan.
FAU - Takeda, Setsuko
AU  - Takeda S
AD  - Central Clinical Laboratory, Osaka City University Hospital, Osaka, Japan.
FAU - Yamashita, Emi
AU  - Yamashita E
AD  - Central Clinical Laboratory, Osaka City University Hospital, Osaka, Japan.
FAU - Yoshida, Yuko
AU  - Yoshida Y
AD  - Central Clinical Laboratory, Osaka City University Hospital, Osaka, Japan.
FAU - Tateishi, Chiharu
AU  - Tateishi C
AD  - Department of Dermatology, Osaka City University Graduate School of Medicine, 
      Osaka, Japan.
FAU - Tsuruta, Daisuke
AU  - Tsuruta D
AD  - Department of Dermatology, Osaka City University Graduate School of Medicine, 
      Osaka, Japan.
FAU - Nakamura, Hiroaki
AU  - Nakamura H
AD  - Department of Orthopaedic Surgery, Osaka City University Graduate School of 
      Medicine, Osaka, Japan.
LA  - eng
PT  - Journal Article
DEP - 20200417
PL  - Italy
TA  - Clin Exp Rheumatol
JT  - Clinical and experimental rheumatology
JID - 8308521
SB  - IM
MH  - *Arthritis, Psoriatic/diagnostic imaging
MH  - *Enthesopathy/diagnostic imaging/etiology
MH  - Humans
MH  - Reproducibility of Results
MH  - Severity of Illness Index
MH  - Ultrasonography
EDAT- 2020/04/18 06:00
MHDA- 2021/02/11 06:00
CRDT- 2020/04/18 06:00
PHST- 2019/12/10 00:00 [received]
PHST- 2020/03/23 00:00 [accepted]
PHST- 2020/04/18 06:00 [pubmed]
PHST- 2021/02/11 06:00 [medline]
PHST- 2020/04/18 06:00 [entrez]
AID - 15073 [pii]
AID - 10.55563/clinexprheumatol/u8qc6c [doi]
PST - ppublish
SO  - Clin Exp Rheumatol. 2021 Jan-Feb;39(1):139-145. doi: 
      10.55563/clinexprheumatol/u8qc6c. Epub 2020 Apr 17.