Detection of subclinical ultrasound enthesopathy and nail disease in patients at risk of psoriatic arthritis

Acquitter, M.; Miséry, Laurent; Saraux, Alain; Bressollette, L; Jousse‐Joulin, Sandrine

doi:10.1016/j.jbspin.2016.10.005

Cited by 27 publications

(22 citation statements)

References 26 publications

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“…Ultrasound is considered a good tool to evaluate the different components of psoriatic nails [16, 17]. …”

Section: Resultsmentioning

confidence: 99%

Nail psoriasis – what a rheumatologist should know about

Nieradko-Iwanicka

2017

Reumatologia

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Psoriasis is a chronic recurrent inflammatory skin disease with prevalence of 1–3%. Nail psoriasis affects 10–90% of patients with plaque psoriasis.The aim of the article is to review the literature for the correlation between nail psoriasis and psoriatic arthritis (PsA) to provide rheumatologists a short review on features of nail psoriasis, methods of their assessment and possible clinical repercussions.The PubMed database was searched using the key words ‘nail psoriasis’ and ‘psoriatic arthritis’. Psoriasis involving the nail matrix shows up as changes such as pitting, Beau lines, leukonychia, red spots in the lunula, or nail plate crumbling. Nail bed psoriasis manifests as onycholysis, oil drops (or salmon patches), dyschromia, splinter hemorrhages, or subungual hyperkeratosis. Nail psoriasis and psoriatic lesions in the gluteal cleft and on the scalp usually accompany PsA, especially in adult men.

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“…Ultrasound is considered a good tool to evaluate the different components of psoriatic nails [16, 17]. …”

Section: Resultsmentioning

confidence: 99%

Nail psoriasis – what a rheumatologist should know about

Nieradko-Iwanicka

2017

Reumatologia

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“…was not able to demonstrate a difference in nail bed thickness between patients with PsO and controls [31]. Comparing 2 groups with PsO, one with nail disease and other with scalp PsO and/or inverse PsO, Acquitter et al (2016) reported that the former group presented with statistically higher nail matrix thickness than patients in the latter group [30]. It was not possible to identify in the studies a comparison between PsO and PsA patients in terms of nail bed thickness with statistical significant differences.…”

Section: Psamentioning

confidence: 96%

“…Study subjects were appropriately described in all included studies, and valid methods to determine the presence of the pathological condition were used and extensively described. The statistical analysis plan was deemed appropriate for the 15 studies [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. Overall, the risk of bias was assessed as moderate to high due to the small sample size of the studies.…”

Section: Assessment Of Biasmentioning

confidence: 99%

“…Twelve studies reviewed gray-scale findings [26,[28][29][30][31][33][34][35][36][37][38][39]. Three of these studies were only pictorial essays, which were purely descriptive [41][42][43].…”

Section: Gray-scale Features Of the Nail By Ultrasonographymentioning

confidence: 99%

“…assess severity of nail matrix and bed PsO by area of involvement in the nail unit) than those with true (i.e., marked) abnormalities on US (median mNAPSI, 10 [1-56] vs 17 ; p = 0.03), with a moderate absolute agreement between US and clinical assessment (76.3% with κ = 0.52, p < 0.0001) [37]. The studies also investigated nail thickness using US, reporting an increased thickness of nail plate, bed, and matrix in patients with PsO and/or PsA compared with controls [26,28,30,31,37,39] (Table 3). Marina et al…”

Section: Controlsmentioning

confidence: 99%

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The use of ultrasonography in the diagnosis of nail disease among patients with psoriasis and psoriatic arthritis: a systematic review

2019

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Background: Nail involvement has been described as a key clinical feature for both psoriasis (PsO) and psoriatic arthritis (PsA) and is an important risk factor in PsA. Thus, early diagnosis of nail involvement may be essential for better management of PsO and PsA. Ultrasonography is considered a highly promising method to visualize nail disease. The main aim of this review was to evaluate the use of ultrasonography for the diagnosis of nail disease in patients with PsO and PsA by reviewing ultrasound parameters with the best diagnostic accuracy. Main body of the abstract: A systematic search was performed in MEDLINE via the PubMed and LILACS databases. Conference proceedings of relevant rheumatology scientific meetings were also screened. Results: After applying eligibility criteria, only 13 articles and 5 abstracts were included in this review. The selected studies showed a huge variability in evaluation methods (and therefore in the results) and were mainly focused on the assessment of nails ultrasound parameters that may differ among patients and healthy controls, especially the morphological aspects in B-mode ultrasonography and vascularization of the nail bed by Doppler ultrasonography. Our research indicated that the evaluation of nail disease in PsO and PsA is still underrepresented in the literature, probably reflecting a restricted use in clinical practice, despite the widespread use of ultrasonography in the management of chronic arthritis. Short conclusions: Despite the potential relevance of ultrasonography for the diagnosis of nail disease, additional studies are needed to determine which features are more reliable and clinically pertinent to ensure accuracy in the evaluation of nail involvement in PsO and PsA.

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Systematic study on nail plate assessment: differences in nail plate shape, thickness, power Doppler signal and scanning approach

et al. 2022

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Ultrasonography (US) of the nail is raising interest in the last years and its feasibility, quickness and amount of descriptive data may provide valuable information. Different authors presented several scanning approaches to nail complex in different pathological conditions, such as psoriasis, but no scanning protocol was ever proposed using healthy subjects as population of reference. The aim of the study was to establish a protocol for the US of nail plate and to assess whether the measurement of the nail plate is influenced by longitudinal vs transverse scan, sex, digit and hand dominance. Using high frequency probe and a Canon Aplio i800 machine, ultrasonographers took scans of nail plates of the hands from healthy subjects. Nail plate shape, thickness and power Doppler signal (PDUS) were evaluated and scans were taken both on longitudinal and transverse axis, at distal, middle and proximal portion of the nail plate or at a fixed angles of − 45°, 0° or + 45°. All the images were then revised and scored using a DICOM software, in order to allow good standards of accuracy and reproducibility. A total of 27 subjects (14 females and 13 males) were assessed. The measures did not result to differ in different portions or angles. Furthermore, no difference appears in sex or dominant vs not dominant hand. A decreasing and significant trend for nail plate thickness was found from the first to the fifth finger. Doppler signal was found in all but one subjects, with a range from almost absent to very evident. No difference was found between groups regarding PDUS. The data provided suggest that a proper scan protocol should include all the nails and evaluation should be done both on longitudinal and transverse axis. Since Doppler signal is highly variable in healthy subjects, its presence should be carefully considered as pathological finding. Observations provided by this study clarify important points of the scanning technique and solve doubts related to which nails should be scanned and where to evaluate quantitative parameters.

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Detection of subclinical ultrasound enthesopathy and nail disease in patients at risk of psoriatic arthritis

Cited by 27 publications

References 26 publications

Nail psoriasis – what a rheumatologist should know about

Nail psoriasis – what a rheumatologist should know about

The use of ultrasonography in the diagnosis of nail disease among patients with psoriasis and psoriatic arthritis: a systematic review

Systematic study on nail plate assessment: differences in nail plate shape, thickness, power Doppler signal and scanning approach

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