Enthesitis: A hallmark of psoriatic arthritis

Kaeley, Gurjit S.; Eder, Lihi; Aydın, Sibel Zehra; Gutiérrez, Marwin; Bakewell, Catherine J.

doi:10.1016/j.semarthrit.2017.12.008

Cited by 146 publications

(121 citation statements)

References 92 publications

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“…In addition, Graceffa et al also demonstrated entheseal thickening in larger entheses in PsA and Pso patients, and assumed that these distinct changes were triggered by inflammation [31]. Along with our findings, this contributes to the concept of "enthesitis being a hallmark of PsA," even though we only considered patients with PsA, but not with Pso [25]. Further studies evaluating differences of pulley thickness and inflammation between patients with PsA, skin Pso, and nail Pso would be of great interest.…”

Section: Discussionsupporting

confidence: 82%

“…The Outcome Measures for Rheumatoid Arthritis Clinical Trials (OMERACT) working group has developed a semi-quantitative PsA MRI (sum-)score (PsAMRIS) that is highly sensitive for disease-related joint changes and is widely used for therapy monitoring [22][23][24]. However, until most recently, enthesitis was not included in any MRI score, despite being a hallmark of PsA [25,26]. Indeed, enthesitis is difficult to accurately evaluate in small joints using conventional MRI or with high-resolution MRI surface coils that can only visualize a small area.…”

Section: Introductionmentioning

confidence: 99%

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High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis

et al. 2020

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Background: To evaluate the value of 3 Tesla (T) magnetic resonance imaging (MRI) changes of flexor tendon pulleys for the differentiation of psoriatic (PsA) and rheumatoid arthritis (RA), using a novel 16-channel highresolution hand coil. Methods: Seventeen patients with active PsA, 20 patients with active RA, and 16 healthy controls (HC) underwent high-resolution 3 T MRI using the dedicated 16-channel hand coil. Images were analyzed by three independent readers for the degree of inflammatory changes, thickness of flexor tendon pulleys, and comparison to the outcome measures for RA clinical trials (OMERACT) PsA MRI score (PsAMRIS) and to its sub-scores. For correlation analyses, Spearman rho correlation was calculated. Results: Flexor tendon pulleys were thicker in PsA than in RA patients (mean difference 0.16 mm, p < 0.001) and HC (mean difference 0.2 mm, p < 0.001) and showed a higher degree of associated inflammatory changes (mean difference from RA 4.7, p = 0.048; mean difference from HC 14.65, p < 0.001). Additionally, there was a strong correlation of accessory pulley inflammation and PsAMRIS and its acute-inflammatory sub-scores, flexor tenosynovitis, synovitis, and periarticular inflammation (for the second digit synovitis ρ = 0.72, flexor tenosynovitis ρ = 0.7, overall PsAMRIS ρ = 0.72, p < 0.01). Similar robust correlations were evident in digits 3-5. Weaker correlations were evident in RA (synovitis ρ = 0.49, flexor tenosynovitis ρ = 0.49, periarticular inflammation ρ = 0.4). Conclusion: The assessment of MRI changes of flexor tendon pulleys is potentially beneficial for disease detection in PsA, as well as for its distinction from RA and HC.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis

et al. 2020

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“…The spondyloarthritis (SpA) family of inflammatory joint diseases are united by the presence of axial or peripheral arthritis without the presence of defined autoantibodies, young age of onset, and entheseal origin of inflammation (1,2). Clinically, SpA commonly coexists with gut and skin inflammation in the form of inflammatory bowel disease (IBD) and psoriasis, respectively.…”

Section: Introductionmentioning

confidence: 99%

TYK2 inhibition reduces type 3 immunity and modifies disease progression in murine spondyloarthritis

Gracey

Hromadová

Lim

et al. 2020

Journal of Clinical Investigation

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“…[10][11][12] Enthesitis and dactylitis are characteristic features of PsA and are indicative of erosive forms of the disease and worse prognostic outcomes. 13,14 However, undiagnosed PsA is common in patients with PsO. A meta-analysis revealed that between 10.1% and 15.5% of patients with PsO may have undiagnosed PsA, 15 while other observational studies have shown that even larger proportions of patients with PsO may have undiagnosed PsA.…”

Section: Introductionmentioning

confidence: 99%

Utilization of the validated Psoriasis Epidemiology Screening Tool to identify signs and symptoms of psoriatic arthritis among those with psoriasis: a cross‐sectional analysis from the US‐based Corrona Psoriasis Registry

Mease

Palmer

Hur

et al. 2019

Acad Dermatol Venereol

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Background Despite increasing awareness of the disease, rates of undiagnosed psoriatic arthritis (PsA) are high in patients with psoriasis (PsO). The validated Psoriasis Epidemiology Screening Tool ( PEST ) is a five‐item questionnaire developed to help identify PsA at an early stage. Objectives To assess the risk of possible undiagnosed PsA among patients with PsO and characterize patients based on PEST scores. Methods This study included all patients enrolled in the Corrona PsO Registry with data on all five PEST questions. Demographics, clinical characteristics and patient‐reported outcomes were compared in Corrona PsO Registry patients with PEST scores ≥3 and <3 using t ‐tests for continuous variables and chi‐squared tests for categorical variables; scores ≥3 may indicate PsA. Results Of 1516 patients with PsO, 904 did not have dermatologist‐reported PsA; 112 of these 904 patients (12.4%) scored ≥3 and were significantly older, female, less likely to be working, and had higher BMI than patients with scores <3. They also had significantly longer PsO duration, were more likely to have nail PsO and had worse health status, pain, fatigue, Dermatology Life Quality Index and activity impairment. Conclusions Improved PsA screening is needed in patients with PsO because the validated PEST identified over one‐tenth of registry patients who were not noted to have PsA as having scores ≥3, who could have had undiagnosed PsA. Appropriate, earlier care is important because these patients were more likely to have nail PsO, worse health‐related quality of life and worse activity impairment.

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Enthesitis: A hallmark of psoriatic arthritis

Cited by 146 publications

References 92 publications

High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis

High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis

TYK2 inhibition reduces type 3 immunity and modifies disease progression in murine spondyloarthritis

Utilization of the validated Psoriasis Epidemiology Screening Tool to identify signs and symptoms of psoriatic arthritis among those with psoriasis: a cross‐sectional analysis from the US‐based Corrona Psoriasis Registry

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