US entheseal abnormalities are present in IBD patients without clinical signs and symptoms of SpA. US enthesopathy is independent of activity, duration and type of gut disease.

The aim of this study was to establish consensus for potential early symptomatic knee osteoarthritis (ESKOA) clinical definition and referral criteria from primary care to rheumatologists, based on available data from literature and a qualitative approach, in order to perform studies on patients fulfilling such criteria and to validate the obtained ESKOA definition. A complex methodological approach was followed including: (1) three focus groups (FG), including expert clinicians, researchers and patients; (2) a systematic literature review (SLR); (3) two discussion groups followed by a Delphi survey. FG and SLR were performed in parallel to inform discussion groups in order to identify relevant constructs to be included in the modified Delphi survey. ESKOA is defined in the presence of: (a) two mandatory symptoms (knee pain in the absence of any recent trauma or injury and very short joint stiffness, lasting for less than 10 min, when starting movement) even in the absence of risk factors, or (b) knee pain, and 1 or 2 risk factors or (c) three or more risk factors in the presence of at least one mandatory symptom, with symptoms lasting less than 6 months. These criteria are applicable in the absence of active inflammatory arthritis, generalized pain, Kellgren-Lawrence grade >0, any recent knee trauma or injury, and age lower than 40 years. Knee pain in the absence of any recent trauma lasting for less than 6 months was considered as the referral criterion to the rheumatologist for the suspicion of ESKOA. This consensus process has identified provisional clinical definition of ESKOA and defined potential referral criterion to rheumatologist, in order to test ESKOA obtained definition in prospective validation studies.

Background In early phase of Psoriatic arthritis (ePsA), US abnormalities might be sub-clinical and independent to psoriasis. Objectives To investigate the ultrasonography (US) dactylitis abnormalities in early PsA patients and to compare them to dermatological, genetic and activity indices. Methods 112 early PsA diagnosed with CASPAR criteria, were studied with MyLab70 Xview (linear probe 15 MHz) US examination of hand fingers. At US, were evaluated the Power Doppler positive synovitis (PS), the tenosynovitis-peritendinitis (TP) of flexors/extensors and the pseudotenosynovitis (PT) (PD subcutaneous signal around flexor tendons) and their correlation with dermatological (presence/absence of psoriasis, presence/absence of palmar psoriasis, presence/absence of nail dystrophy, PASI), genetic (positivity/negativity of HLAB27, B35, B38, CW6, CW7, DR1, DR4) and activity indices (BASDAI, HAQ modified for spondyloarthritis [SHAQ], normality or elevation of ESR, CRP). Results At US, in ePsA, US abnormalities at fingers were present in different percentage: 25,9% (29/112) PD positive synovitis (PS), 17,8% (20/112) tenosynovitis-peritendinitis (TP), 14,3% (16/112) pseudotenosynovitis (PT). At Yates X square test analysis, US parameters correlated to the presence of these three parameters: psoriasis (all p<0,0001), palmar psoriasis (PS p<0,005), nail dystrophy (PS p<0,05, PT p<0,0001), B27 (PS p<0,0001, TP p<0,01, PT p<0,05), B35 (PS p<0,05), B38 (PS p<0,0001, TP p<0,0001, PT p<0,005), CW7 (PS p<0,0001), DR4 (PS p<0,0001, TP p<0,0001, PT p<0,005), CRP (all p<0,0001), ESR (PS p<0,0005, TP p<0,0001, PT p<0,0001). At Pearson correlation, US abnormalities are independent to PASI, BASDAI and SHAQ. Conclusions Dactylitis US abnormalities are correlated to the presence of psoriasis, HLA aplotypes B27-B35-B38-CW7-DR4 and CRP/ESR elevation, while are independent to severity of dermatologic involvement and clinical indices. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4283

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