Axial Involvement in Psoriatic Arthritis: Effect on Peripheral Arthritis and Differential Features With Axial Spondyloarthritis in South America

Salinas, Rodrigo García; Prado, Einer Sanchez; Ruta, Santiago

doi:10.3899/jrheum.201627

Cited by 4 publications

(3 citation statements)

References 9 publications

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“… 22 - 25 In our previously published cohort of PsA and axial SpA, we found a difference between the presence of clinical enthesitis and enthesitis by US at diagnosis, in PsA, 30% had clinical enthesitis and 45% by US and in axial spondyloarthritis (SpA), it was 42% and 69%, respectively. 8 , 26 …”

Section: Discussionmentioning

confidence: 99%

Psoriatic Arthritis: Differential Features at the Time of Clinical Presentation in a Large Cohort of Patients with Polyarthralgia

Ruta¹,

Cespedes²,

Cuellar³

et al. 2023

Eur J Rheumatol

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Objective: Most patients with psoriatic arthritis begin with cutaneous psoriasis, which is why all early detection strategies are based on screening in the dermatological consultation and referral to a rheumatologist. However, there are cases of patients who consult initially for musculoskeletal symptoms, mostly joint pain, regardless of family and/or personal history of psoriasis. This study aimed to estimate the frequency of psoriatic arthritis in a cohort of patients who consulted for polyarthralgia and to determine the differential features, at the time of clinical presentation, in relation to both patients with final diagnosis other than psoriatic arthritis and patients with diagnosis of rheumatoid arthritis. Methods: Consecutive patients with polyarthralgia (including arthralgia of the hands) were included. Clinical examination, laboratory tests, ultrasound with power Doppler of both hands, and radiography of both hands and feet were performed at baseline. All patients were followed up and the definitive diagnosis of psoriatic arthritis was established. Results: A total of 1055 were included, 88 (8.3%) ended with diagnosis of psoriatic arthritis. Diagnosis of psoriatic arthritis was positively associated with a family history of psoriasis (odds ratio = 4.14), psoriasis (odds ratio = 78.94), radiographic erosions (odds ratio = 5.74), and ultrasound with at least 1 joint with positive power Doppler (odds ratio = 7.11). In comparison with rheumatoid arthritis patients, diagnosis of psoriatic arthritis was positively associated with psoriasis (odds ratio = 433.42) and family history of psoriasis (odds ratio = 41.63). On the other hand, it was negatively associated with positivity, for both rheumatoid factor (odds ratio = 0.03) and anti-cyclic citrullinated peptide antibodies (odds ratio = 0.06). Conclusion: The frequency of psoriatic arthritis was 8.3% and was associated with a personal and/or family history of psoriasis, radiographic erosions, and inflammatory involvement by Power Doppler Ultrasound (PDUS). In comparison with rheumatoid arthritis patients, psoriatic arthritis was associated with a personal and/or family history of psoriasis, while the presence of both rheumatoid factor and/or anti-cyclic citrullinated peptide antibodies was shown to be a protective factor for the diagnosis of psoriatic arthritis.

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Section: Discussionmentioning

confidence: 99%

Psoriatic Arthritis: Differential Features at the Time of Clinical Presentation in a Large Cohort of Patients with Polyarthralgia

Ruta¹,

Cespedes²,

Cuellar³

et al. 2023

Eur J Rheumatol

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“…The term psoriatic SpA is used for cases that share features of both entities [ 25 ]. Axial PsA patients seem to have similar sex predominance, disease activity, and functionality, but PsA patients are older at diagnosis time, with a median age of 49 years old, compared to 43 years old for AS patients, with much more smokers in the PSA group [ 27 ]. Moreover, SpA is genetically and immunologically linked to inflammatory bowel disease (IBD); thus, IBD may predict arthritis and two out of three SpA patients have subclinical IBD, with similar changes as those encountered in Crohn’s disease [ 70 ].…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, SpA is genetically and immunologically linked to inflammatory bowel disease (IBD); thus, IBD may predict arthritis and two out of three SpA patients have subclinical IBD, with similar changes as those encountered in Crohn’s disease [ 70 ]. IBD has a similar incidence in axial PsA and SpA and a higher incidence in pediatric patients with jPsA or psoriasis-associated conditions in JIA [ 11 , 27 ].…”

Section: Resultsmentioning

confidence: 99%

MRI Findings in Axial Psoriatic Spondylarthritis

et al. 2023

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Psoriatic arthritis is a significant medical condition with a high prevalence, a wide variety of non-specific symptoms, and a high degree of overlap with other spondylarthritis disorders, particularly ankylosing spondylitis. Hence, knowledge of the magnetic resonance imaging (MRI) manifestations and a multidisciplinary strategy are required for the better management of these patients. We searched publications from the last 10 years and focused on the most relevant ones which discussed the classification criteria, the MRI characteristics of axial psoriatic arthritis, the importance of MRI for follow up, and the reliability of skin and synovial biopsy. Axial spondylarthritis can be diagnosed and followed up on using the well-established MRI technique and, additionally, a biopsy. The analysis and concordance between them can provide new directions for future studies.

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