Early detection of spondyloarthropathy in patients with psoriasis by using the ultrasonography and magnetic resonance image

Hamdy, Maha; Omar, Gihan; El-Shereef, Rawhya R.; Ellaban, Abdou S; Amin, Mohamed Ahmed

doi:10.5152/eurjrheumatol.2015.0075

Cited by 15 publications

(10 citation statements)

References 20 publications

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“…In addition, our results were consistent with the previous results of FitzGerald and Gladma 18 that revealed that the presence of rheumatic complains especially LBP is a strong predictor of early axSpA changes in patients with PsA. Hamdy et al19 also reported that the presence of inflammatory back pain was the most important clinical feature associated with early signs of MRI sacroiliitis.…”

supporting

confidence: 93%

“…Although there are several suggestive indicators and predictors for detecting early axSpA changes in patients with psoriasis and PsA regarding clinical and MRI findings, 6,18‐21 from our point of view this study proved that IL‐17A is the most accurate and the preferred method for detecting the early sub‐clinical axSpA changes in patients with nr‐axSpA (patients with inflammatory LBP with normal X‐ray findings) and asymptomatic psoriatic patients as it is a more precise and objective test than clinical data and has a low cost compared to MRI but with an equal prognostic value.…”

Section: Discussionmentioning

confidence: 66%

“…Our results revealed that the severity of skin lesions is an independent risk factor of early axSpA changes in patients with psoriasis and PsA, and this is in agreement with Scher et al 6 as they reported that the severity of psoriatic skin lesions was strongly associated with the future development of early axSpA changes in psoriatic patients. The present study reported a significant correlation between and PsA regarding clinical and MRI findings, 6,[18][19][20][21] from our point of view this study proved that IL-17A is the most accurate and the preferred method for detecting the early sub-clinical axSpA changes in patients with nr-axSpA (patients with inflammatory LBP with normal X-ray findings) and asymptomatic psoriatic patients as it is a more precise and objective test than clinical data and has a low cost compared to MRI but with an equal prognostic value.…”

Section: Discussionmentioning

confidence: 85%

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Interleukin‐17A biomarker as a predictor for detection of early axial spondyloarthritis changes in patients with psoriasis

et al. 2020

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Aim: Although the pathogenic mechanisms of psoriatic arthritis (PsA) are not completely clarified, evidence suggests that interleukin 17A (IL-17A)-mediated immune responses play a pivotal role in the disease. This is best underscored by the important clinical effectiveness of IL-17A inhibitors in psoriasis treatment. We aim to investigate the predictive value of IL-17A in detecting the early axial spondyloarthropic (SpA) changes in psoriatic patients. Methods: The study enrolled 100 patients with psoriasis, classified into group 1, included 62 patients with only psoriatic skin lesions (Ps), and group 2 included 38 patients with PsA, and 100 age and gender matched healthy volunteers. All participants were subjected to general and local clinical examination, laboratory assessment including IL-17A in the serum by means of enzyme-linked immunosorbent assay, and axial joint radiological assessment. Results: Our study included 60 males (60%) and 40 females (40%).The positive radiological findings of early axial SpA changes were found among 30.6% of the Ps group and among 84.2% of the PsA group. There were significant differences between patients with positive magnetic resonance imaging (MRI) findings of early axial SpA and patients with negative MRI findings in both groups regarding IL-17A levels. There was a significant association between IL-17A level and early axial SpA changes in psoriatic patients with a clear cutoff point (222.5). Conclusion: Our study can imply that IL-17A is a valuable, useful and low-cost biomarker in detecting early axial SpA changes in asymptomatic and nonradiographic axial SpA (nr-axial SpA) psoriatic patients that helps early management and prevent progressive axial involvement and disabilities.

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supporting

confidence: 93%

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 85%

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Interleukin‐17A biomarker as a predictor for detection of early axial spondyloarthritis changes in patients with psoriasis

et al. 2020

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“…Therefore, it is necessary to rely on imaging rather than clinical examination in order to detect non-accessible sites of entheses. Indeed, numerous studies have shown that ultrasound (US) could detect a subclinical enthesitis in PsA patients [ 34 – 36 ].…”

Section: Evaluating Enthesitismentioning

confidence: 99%

Enthesitis: Much More Than Focal Insertion Point Inflammation

et al. 2018

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Purpose of ReviewRecognition of the importance of enthesitis as the pivotal pathological process underpinning spondyloarthropathies (SpA) has increased in recent years. Thus, we summarized the current knowledge on the pathogenic role of enthesitis on SpA shown by both animal models and human studies in vivo.Recent FindingsExperimental models have shown several SpA-like diseases that commence at entheses and are linked to nail disease as well as dactylitis, two important entheseal-associated conditions in humans. Frequently, enthesitis is not the primary outcome measure in studies of peripheral PsA and SpA although arguably it is the key parameter being indirectly assessed in spinal disease in ankylosing spondylitis. The use of different agents including JAK, IL-17, and IL-23 inhibitors contributes significantly to our understanding of enthesitis in terms of involved immune pathways.SummaryEnthesitis and enthesis organ inflammation may be the primary pathological process underlying SpA associated skeletal inflammation. Emergent studies are beginning to elucidate the molecular basis for this type of joint inflammatory response.

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“…The ultrasound images may detect early involvement of joints and tendons; moreover, some specific ultrasonographic patterns of PsA have been used in the differential diagnosis between PsA and rheumatoid arthritis. 8,9 Without regularity, she had used deflazacort, NSAID, and methotrexate with improvement of symptoms. Notwithstanding, the role of prevention and control of risk factors of severe forms of disease and associated comorbidities should be emphasized in this group of patients.…”

Section: Psoriatic Arthritismentioning

confidence: 99%

An old woman with chronic palmar dermatosis, rheumatism, and nail changes

Santos

Pedrosa²,

Ferreira

et al. 2017

Ital J Med

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This 71-year-old Brazilian woman was admitted because of asthenia, palpitations, progressive breathlessness, and paroxysmal nocturnal dyspnea in the last three months. She also complained of a constrictive precordial pain irradiating to dorsum, fatigue and morning hand stiffness. Seven days before admission the cardiac scintigraphy showed discrete contractility changes. Medical antecedents were dermatosis over than 10 years, and rheumatism nearly 8 years; and intermittently used deflazacort, non-steroidal anti-inflammatory drug (NSAID), and methotrexate with good clinical response. She denied occurrence of fever, anorexia, loss of weight, and urinary changes; but presented one episode of melena first attributed to acute mucosal lesions due to medicines. However, both upper digestive endoscopy and colonoscopy evaluations were unremarkable. Physical examination revealed body mass index: 28 kg/m 2 ; and vital signs were temperature: 36.5°C, blood pressure: 110/70 mmHg, heart rate: 78 beats/min, and respiratory rate: 16 breaths/min. There were bilateral ulnar deviation of the wrists, painful hypertrophic changes in the interphalangeal joints and in the right sternoclavicular joint, and pain in the Achilles tendons. Moreover, bilateral palmar patches with lamellar desquamation; pitting, transverse grooves, and some transverse over curvature were detected in hands nails (Figure 1). Laboratory determinations showed hemoglobin: 11.5 g/dL, hematocrit: 37.1%, leukocytes: 5198/mm 3 , platelets: 105,000/mm 3 , erythrocyte sedimentation rate: 41 mm/h, C-reactive protein: 0.4 mg/dL, rheumatoid factor: 11 IU/mL, anti-nuclear antibody (immunofluorescence on HEp-2 cells): negative, triglycerides: 93 mg/dL, total cholesterol: 170 mg/dL, high-density lipoprotein cholesterol: 43 mg/dL, low-density lipoprotein cholesterol: 108 mg/dL, iron: 66 mcg/dL, albumin: 3.9 g/dL, globulins: 2.7 (α1: 0.2, α2: 0.5, β1: 0.6, β2: 0.5, γ: 0.9) g/dL, vitamin D: 14.6 ng/mL, immunoglobulin (Ig) G: 978 mg/dL, IgM: 177.9 mg/dL, transferrin: 357 mg/dL, transferrin saturation: 15%, glycated hemoglobin: 5.6%, potassium: 3.7 mmol/L, urea: 18.3 mg/dL, creatinine: 0.65 mg/dL, alanine aminotransferase: 46.6 IU/L, aspartate aminotransferase: 57.2 IU/L, thyroid-stimulating hormone: 1.53 mcIU/mL, free T4: 0.9 ng/dL, serologic tests for HIV and viral hepatitis: negative. The bone scintigraphy study showed hypercaptation in her shoulders, elbows, ABSTRACTPsoriasis is a chronic inflammatory condition with variable changes on the skin and nails, sometimes associated with osteoarticular manifestations characterizing the psoriatic arthritis. This arthritis may precede, follow, or be concomitant with the skin lesions of psoriasis. Unsuspected psoriatic arthritis may be misdiagnosed by other seronegative spondyloarthritis, mainly in primary care attention, and ominous outcomes are related to late and inadequate management. Therefore, diagnostic exercises with base on significant clinical and radiological images might contribute to enhance the suspicion index about these...

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Early detection of spondyloarthropathy in patients with psoriasis by using the ultrasonography and magnetic resonance image

Cited by 15 publications

References 20 publications

Interleukin‐17A biomarker as a predictor for detection of early axial spondyloarthritis changes in patients with psoriasis

Interleukin‐17A biomarker as a predictor for detection of early axial spondyloarthritis changes in patients with psoriasis

Enthesitis: Much More Than Focal Insertion Point Inflammation

An old woman with chronic palmar dermatosis, rheumatism, and nail changes

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