Development of Criteria to Distinguish Inflammatory from Noninflammatory Arthritis, Enthesitis, Dactylitis, and Spondylitis: A Report from the GRAPPA 2013 Annual Meeting

Mease, Philip J.; Garg, Amit; Helliwell, Philip S.; Park, Jane J; Gladman, Dafna D.

doi:10.3899/jrheum.140182

Cited by 25 publications

(20 citation statements)

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“…In our sample, bilaterality was found in 86.1, 76.1 and 89.7% of patients reporting tenderness in at least two enthesis in MASES, SPARCC and LEI, respectively. This result reinforces the importance of "bilaterality" in the assessment of enthesitis [35].…”

Section: Discussionsupporting

confidence: 81%

Correlation of enthesitis indices with disease activity and function in axial and peripheral spondyloarthritis: a cross-sectional study comparing MASES, SPARCC and LEI

et al. 2019

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Background: The presence of enthesitis is associated with higher disease activity, more disability and incapacity to work and a poorer quality of life in spondyloarthritis (SpA). There is currently no consensus on which clinical score should be used to assess enthesitis in SpA. The objective of the present work was to compare the correlation of three enthesitis indices (MASES, SPARCC and LEI) with measures of disease activity and function in a heterogeneous population of patients with axial and peripheral SpA. Methods: A cross-sectional study was conducted in three Brazilian public university hospitals; patients fulfilling ASAS classification criteria for peripheral or axial SpA were recruited and measures of disease activity and function were collected and correlated to three enthesitis indices: MASES, SPARCC and LEI using Spearman's Correlation index. ROC curves were used to determine if the the enthesitis indices were useful to discriminate patients with active disease from those with inactive disease. Results: Two hundred four patients were included, 71.1% (N = 145) fulfilled ASAS criteria for axial SpA and 28.9% (N = 59) for peripheral SpA. In axial SpA, MASES performed better than LEI (p = 0.018) and equal to SPARCC (p = 0.212) regarding correlation with disease activity (BASDAI) and function (BASFI). In peripheral SpA, only MASES had a weak but statistical significant correlation with DAS28-ESR (r s 0.310 p = 0.05) and MASES had better correlation with functional measures (HAQ) than SPARCC (p = 0.034). Conclusion: In this sample composed of SpA patients with high coexistence of axial and peripheral features, MASES showed statistical significant correlation with measures of disease activity and function in both axial and peripheral SpA.

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Section: Discussionsupporting

confidence: 81%

Correlation of enthesitis indices with disease activity and function in axial and peripheral spondyloarthritis: a cross-sectional study comparing MASES, SPARCC and LEI

et al. 2019

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“…In these cases, joint aspiration and microscopic detection of crystals are helpful diagnostic tools. 13Box 5| Early screening of psoriatic arthritis To facilitate early recognition of psoriatic arthritis (PsA), new screening instruments are being explored for non-experts, in particular patient questionnaires using lay definitions of inflammatory musculoskeletal disease (187). 188 (194) [H1] Family-oriented questionnaires (195,196)  Psoriasis Family Impact (PFI)  Family Dermatology Life Quality Index (FDLQI)  Family Reported Outcome Measure (FROM-16)…”

Section: [H1] Outlookmentioning

confidence: 99%

Psoriasis

Greb

Goldminz

Elder

et al. 2016

Nat Rev Dis Primers

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736

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Psoriasis is a chronic, immune-mediated disorder with cutaneous and systemic manifestations and substantial negative effects on patient quality of life. Psoriasis has a strong, albeit polygenic, genetic basis. Whereas approximately half of the accountable genetic effect of psoriasis maps to the major histocompatibility complex, >70 other loci have been identified, many of which implicate nuclear factor-κB, interferon signalling and the IL-23-IL-23 receptor axis. Psoriasis pathophysiology is characterized by abnormal keratinocyte proliferation and immune cell infiltration in the dermis and epidermis involving the innate and adaptive immune systems, with important roles for dendritic cells and T cells, among other cells. Frequent comorbidities are rheumatological and cardiovascular in nature, in particular, psoriatic arthritis. Current treatments for psoriasis include topical agents, photo-based therapies, traditional systemic drugs and biologic agents. Treatments can be used in combination or as monotherapy. Biologic therapies that target specific disease mediators have become a mainstay in the treatment of moderate-to-severe disease, whereas advances in the treatment of mild-to-moderate disease have been limited.

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“…Further work is ongoing to define the features of inflammatory musculoskeletal disease as quoted in the stem of the CASPAR criteria. 11 Generally, laboratory tests are unhelpful: markers of systemic inflammation, such as the C-reactive protein or erythrocyte sedimentation rate, may be elevated in only 50% of cases and low titre rheumatoid factor and anti-cyclic citrullinated peptide may be found in up to 10% of cases. 4 Current National Institute for Health and Care Excellence guidance for the management of psoriasis suggests that the Psoriasis Epidemiology Screening Tool patient-completed screening questionnaire 12 ( www.bad.org.…”

Section: Diagnosismentioning

confidence: 99%

Psoriatic arthritis: state of the art review

2017

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Psoriatic arthritis (PsA) accounts for around 20% of referrals to the early arthritis clinic and presents a signifi cant diagnostic and management challenge. Early diagnosis is important to prevent long term functional disability and to ensure optimal management of arthritis and key comorbidities. From the rheumatologist's perspective, the differential diagnosis includes rheumatoid arthritis, gout and other infl ammatory arthritides. Once diagnosed, it is essential to assess the disease fully, including arthritis, enthesitis, dactylitis, skin/ nail disease and axial involvement. Using this information, appropriate treatment can be planned using therapies that are effective at treating the relevant domains of disease. Despite poor data, traditional disease-modifying anti-rheumatic drugs are commonly used and have been effective in observational studies. Following tumour necrosis factor inhibitors, which have proven excellent effi cacy in multiple domains of PsA, new biologics are available or in development and will improve treatment options for people with refractory PsA. IntroductionIn 1964, psoriatic arthritis (PsA) was recognised as a separate disease by the American Rheumatism Association (now the American College of Rheumatology), and is now included as a member of the spondyloarthropathy spectrum.1 PsA was initially defined by Moll and Wright as 'an inflammatory arthritis in the presence of psoriasis with a usual absence of rheumatoid factor', 2 but newer more robust classification criteria are discussed in this article. Why is it important to recognise PsA?Although PsA was thought initially to be a relatively benign disorder, registry data has shown the destructive and progressive nature of the disease; 4 it has a similar impact on quality of life and functional ability as in rheumatoid arthritis. 5 ABSTRACT Psoriatic arthritis: state of the art reviewIn recent years, the additional burden of increased mortality and significant cardiovascular comorbidity has also been identified. 6 Despite this, identification and treatment are still not optimal. There are significant delays in diagnosis for the majority of patients (typically, in screening studies, up to 50% of established cases have not previously been identified).7 Delay in diagnoses of 6 and 12 months have been shown to impact on long-term joint damage and functional disability. 8,9 DiagnosisPsA is a heterogeneous condition with musculoskeletal involvement, including arthritis, enthesitis, dactylitis and axial involvement as well as potential skin and nail disease. Different patterns of involvement of PsA can mimic different inflammatory arthritides.For the rheumatologist, a patient presents with inflammatory arthritis and the differential diagnosis can include rheumatoid arthritis, crystal arthropathies and other inflammatory arthritides. When differentiating from rheumatoid arthritis, particularly in polyarticular PsA, there are a number of features Key pointsPsoriatic arthritis is an heterogeneous disease with multiple musculoskeletal and dermatol...

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Development of Criteria to Distinguish Inflammatory from Noninflammatory Arthritis, Enthesitis, Dactylitis, and Spondylitis: A Report from the GRAPPA 2013 Annual Meeting

Abstract: This project will lead to the development of practical criteria to aid in the diagnosis and appropriate clinical care of patients with chronic inflammatory musculoskeletal conditions.

Cited by 25 publications

References 8 publications

Correlation of enthesitis indices with disease activity and function in axial and peripheral spondyloarthritis: a cross-sectional study comparing MASES, SPARCC and LEI

Correlation of enthesitis indices with disease activity and function in axial and peripheral spondyloarthritis: a cross-sectional study comparing MASES, SPARCC and LEI

Psoriasis

Psoriatic arthritis: state of the art review

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