Reliability, validity and feasibility of nail ultrasonography in psoriatic arthritis

Arbault, Anaïs; Devilliers, H.; Laroche, Davy; Cayot, Audrey; Vabres, P.; Maillefert, Jean-Françis; Ornetti, Paul

doi:10.1016/j.jbspin.2015.11.004

Cited by 23 publications

(16 citation statements)

References 29 publications

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“…There are few studies of specific nail findings, and these have disparate results. In 2015, Arbault realized a prospective study of eight ultrasonography parameters in 27 patients with psoriatic arthritis. Of these, 67% presented nail involvement on US vs. 37% on physical examination.…”

Section: Discussionmentioning

confidence: 99%

“…There are few studies of specific nail findings, and these have disparate results. In 2015, Arbault 33 realized a prospective study 34 noted that the inflammatory reaction around the DIP joint involves the nail bed in PsA providing a close anatomical link between nail inflammation and joint disease. They also explored this anatomical region histologically and noted that the extensor digitorum tendon crossing the DIP joint was intimately linked with the nail root and its associated matrix.…”

Section: Discussionmentioning

confidence: 99%

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Subclinical enthesopathy of extensor digitorum tendon is highly prevalent and associated with clinical and ultrasound alterations of the adjacent fingernails in patients with psoriatic disease

Alvarado

Crespo

Muñoz-Garza

et al. 2018

Acad Dermatol Venereol

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Enthesopathy abnormalities can be detected by US in patients with psoriasis without musculoskeletal complaints frequently. There is a close relationship between subclinical enthesopathy of the extensor digitorum tendon and the presence of nail alterations. Further studies are required to research what implications have the presence of these ungual alterations measured by US, and how it affects later development of a PsA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Subclinical enthesopathy of extensor digitorum tendon is highly prevalent and associated with clinical and ultrasound alterations of the adjacent fingernails in patients with psoriatic disease

Alvarado

Crespo

Muñoz-Garza

et al. 2018

Acad Dermatol Venereol

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“…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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Ultrasound Assessment of Psoriatic Arthritis Patients With Clinically Normal Nails and Evaluation of its Correlation With the Disease Activity

Mahmoud,

Rouached,

Rahmouni

et al. 2024

J of Ultrasound Medicine

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ObjectivesNail unit is one of the targets of ultrasound (US) assessment. We aimed to compare ultrasound parameters of clinically normal nail unit in psoriatic arthritis (PsA) patients with healthy controls (HC) and evaluate their correlations with disease activity.MethodsThis was a cross‐sectional study including patients with PsA and matched HC. Tender (TJC) and swollen joint count (SJC), Psoriasis Area and Severity Index (PASI), and Disease Activity in Psoriatic Arthritis (DAPSA) were collected in PsA patients.Patients underwent US assessment of fingernails with a study of morphological changes and measurement of the thickness of nail bed (NBT), nail plate (NPT), and adjacent skin (ST). Correlation between nail unit parameters and disease activity was studied.ResultsWe evaluated 22 PsA patients (219 nails) and 21 HC (210 nails). Mean DAPSA was 21.56 ± 14.36 and mean PASI was 2.19 ± 3.8.PsA patients had more US morphological changes than HC (16.89 vs 3.33%, P = .03). NPT comparison between identical fingernails of PsA and HC did not reveal significant difference. However, NBT was significantly higher in HC (1.77 vs 2.07 mm, P = .027) as well as ST (2.26 vs 2.59 mm, P = .003).TJC and ST were positively correlated (r = .46, P = .03). No correlation was noted between disease activity scores and NPT, NBT, or ST in PsA patients. In biologic parameters, ESR was negatively correlated with ST (r = −.41, P = .05).ConclusionsNail bed and adjacent skin US morphological changes were contributive to distinguish psoriatic from healthy nails. Adjacent skin thickness measurement was positively correlated with TJC and ESR, suggesting that it could be used as an indicator of disease activity in PsA.

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Reliability, validity and feasibility of nail ultrasonography in psoriatic arthritis

Cited by 23 publications

References 29 publications

Subclinical enthesopathy of extensor digitorum tendon is highly prevalent and associated with clinical and ultrasound alterations of the adjacent fingernails in patients with psoriatic disease

Subclinical enthesopathy of extensor digitorum tendon is highly prevalent and associated with clinical and ultrasound alterations of the adjacent fingernails in patients with psoriatic disease

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

Ultrasound Assessment of Psoriatic Arthritis Patients With Clinically Normal Nails and Evaluation of its Correlation With the Disease Activity

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