scholarly journals SAT0562 ADDITIONAL BENEFIT OF ULTRASOUND TO THE EARLY DIAGNOSIS OF PSORIATIC ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1239.2-1239
Author(s):  
Y. Geng ◽  
A. Cope ◽  
S. Subesinghe ◽  
J. Galloway ◽  
Z. Zhang ◽  
...  

Background:Being an inflammatory disease of joint, spine or enthesis is the premise of the CASPAR diagnostic criteria for psoriatic arthritis (PsA). Traditionally, the assessment of local inflammation in joint, enthesis and tendon relies on physical examinations. But multiple studies have demonstrated that ultrasound (US) is capable of detecting subclinical inflammation as well as non-inflammatory lesions.Objectives:To compare the capabilities of physical examination and US findings in the diagnosis of early PsA, and further identify the US features which are most valuable for the diagnosis of PsA.Methods:66 patients with suspected PsA or early PsA (disease duration< 2 years) due to psoriasis with joint pain or seronegative inflammatory arthritis were enrolled and further assessed by both physical examination and ultrasound (US).Tender and swollen joint counts based on 68/66 joints, tender tendons, enthesitis (14 entheses) and dactylitis (20 digits) count were collected by physical examination. Abnormalities of peripheral joints, entheses and tendons were also evaluated by US. New bone formation was evaluated by hand X-ray. The diagnostic capacity of CASPAR criteria based on US and based on physical examination were compared. The diagnosis value of US features as well as clinical characteristics were analyzed. The clinical diagnosis of PsA by the expert panel was taken as the standard.Results:CASPAR criteria based on US showed a higher specificity than those based on physical examination (96.7% vs. 53.3%) with a bit decrease of sensitivity (91.7% vs. 97.2%). 36 patients were eventually diagnosed as PsA and 30 patients were non-PsA. Gender distribution, mean age and disease duration were equally distributed in two groups of patients. Dermatology Life Quality Index (DLQI) was higher in PsA patients than non-PsA patients. Significantly more patients had nail change and new bone formation on hand X-ray in PsA patients than in non-PsA patients (69.4% vs. 26.7%,P=0.001 and 66.7% vs. 13.3%,P<0.001 respectively). Significantly higher frequencies of synovitis/synovium hypertrophy, tenosynovitis and enthesitis were found in PsA patients than non-PsA patients (58.3% vs 20.0%,P=0.002, 38.9% vs 3.3%,P=0.001 and 52.8% vs 13.3%,P=0.002, respectively). Logistic regression analysis showed that nail change (OR=25.1, P=0.007), new bone formation on X-ray (OR=33.1, P=0.003), tenosynovitis on US (OR=149.1, P=0.003) and enthesitis on US (OR=39.2, P=0.008) were independent risk factors for predicting the diagnosis of PsA.Conclusion:US increased the specificity of CASPAR criteria compared with physical examination. Combined nail change, new bone formation on X-ray, tenosynovitis and enthesitis on US improved the diagnosis of early PsA.References:[1]Polachek A, Cook R, Chandran V, et al. The association between sonographic enthesitis and radiographic damage in psoriatic arthritis. Arthritis Res Ther 2017; 19(1): 189.[2]Faustini F, Simon D, Oliveira I, et al. Subclinical joint inflammation in patients with psoriasis without concomitant psoriatic arthritis: a cross-sectional and longitudinal analysis. Ann Rheum Dis 2016; 75(12): 2068-74.Acknowledgments:The author thank all the colleagues in the department of Rheumatology of Guy’s hospital.Disclosure of Interests:None declared

2020 ◽  
pp. 10-17
Author(s):  
Carolina Isnardi ◽  
Fernando Dal Para ◽  
Eduardo Scheines ◽  
Marina Fornaro ◽  
Osvaldo Cerda ◽  
...  

There are many scores available to measure radiographic joint damage in patients with Psoriatic Arthritis (PsA), but most of them were developed for Rheumatoid Arhtritis and then modified for PsA. These scores do not evaluate juxtaarticular bone proliferation. The aim of our study was to validate the Reductive X-Ray Score for Psoriatic Arthritis (ReXSPA), which was recently developed to be used in observational cohorts. Methods: A cross-sectional study was carried out. Consecutive patients ≥18 years old with sA according to CASPAR criteria were included. All patients underwent X-rays of the hands and feet in an anteroposterior view. Two blind readers for the clinical characteristics of the patients and previously trained, scored them by Sharp van der Heijde modified for PsA (PsA-SvdH) and ReXSPA indexes. Time to read and calculate both scores were measured. Results: A total of 66 patients were included, half of them were female, median (m) disease duration of 8 years (IQR: 4-14.3). 132 X-Rays were scored according to PsA-SvdH [m 35 (IQR: 16.3-72.5)] and ReXSPA [m 22 (IQR: 7-46.3)]. Time to read was significantly shorter for ReXSPA than PsA-SvdH [mean 5.8±2.1 vs mean 7.5±2.5 minutes, p<0.0001], as well as, time to calculate them [mean 26.5±14.7 vs mean 55.3±38.3 seconds, p<0.0001]. The correlation between both indexes was excellent (Rho: 0.93). In the multivariate analysis, using both radiographic scores as dependent variable, association of each of the indices with disease duration was observed, and ReXSPA also had association with age. Conclusion: The ReXSPA index has shown validity and a very good correlation with PsA-SvdH. It is quicker to read and to calculate than PsA-SvdH. Subsequent longitudinal evalua-tions will allow demonstrating the validity of these findings.


2020 ◽  
Author(s):  
Yaqun Huang ◽  
Sha Yan ◽  
Hongfu Xie ◽  
Ben Wang ◽  
Zhixiang Zhao ◽  
...  

BACKGROUND Rosacea is a chronic inflammatory dermatosis with facial skin involved, leading to physical and emotional problems, which greatly affected quality of life (QoL) of patients. Dermatology Life Quality Index (DLQI) and willingness to pay (WTP) are well-established instruments assessing the health-related quality of life (HRQoL), while very few studies have been focused on this topic about rosacea in China. OBJECTIVE To investigate HRQoL in Chinese rosacea patients assessed by DLQI and WTP and investigate potential predictors for patients with HRQoL severely affected. METHODS This cross-sectional study was conducted on 973 patients with rosacea. Sociodemographic data, clinical features and DLQI were collected, and WTP was assessed by three standardized items. Multivariable logistic analysis was performed to investigate independent factors influencing QoL. RESULTS 921 questionnaires were accomplished by participants. The mean DLQI score was 11.6 (median 11). Patients were willing to pay an average of $1050.2 or € 896.2 (median $431.4 or € 368.1) for complete cure. 33.3% would like to pay more than 20% of their monthly income to achieve sustainable control. There were positive correlations between WTP with DLQI (P < .05). DLQI could be independently impacted by age (21-30 and 31-40, OR = 3.242 and 3.617, respectively), the occupational requirement of appearance (high, OR = 4.410), disease duration (< 2 years, OR = 1.582), oedema (OR = 1.844) and severity of flushing, burning, stinging and pruritus (severe, OR = 2.003, 1.981, 2.491, 2.249, respectively). There were no significant associations between WTP and most of the clinical factors. CONCLUSIONS The QoL was negatively affected and should not be ignored among rosacea patients in China. Patients aged 21-40y, having occupational requirement of appearance, with the disease duration less than 2 years, and suffering severe flushing and related symptoms were more likely to have severe or very severe limitation of QoL.


2021 ◽  
Author(s):  
gan zhang ◽  
Xiaosong Chen ◽  
Xunsheng Cheng ◽  
Xiuwu Ma ◽  
Congcong Chen

Abstract Introduction: The experiment was undertaken to estimate the effect of BMSCs seeding in different scaffold incorporation with HBO on the repair of seawater immersed bone defect. And future compared n-HA/PLGA with β-TCP/PLGA as scaffold in treatment effect of seawater immersed bone defect.Methods: 60 New Zealand White rabbits with standard seawater defect in radius were randomly divided to group A (implant with nothing), group B (implanted with atuogenous bone), group C (implanted with n-HA/PLGA/BMSCs, and Group D ( implanted with β-TCP/PLGA/BMSCs). After implant, each rabbit receive HBO treatment at 2.4 ATA 100% oxygen for 120 minutes per day for 2 weeeks. Radiograph, histological and biomechanical examination were used to analyze osteogenesis.Result: X-ray analysis show that n-HA/PLGA/BMSCs and β-TCP/PLGA/BMSCs could accelerate the new bone formation, and the new bone formation in group C was lager than in group D or group A, and close to group B (P<0.05). After 12 weeks, in group A, defect without scaffold show a loose connect tissue filled in the areas. The medullary canal in group B was recanalizated. Defect in group C and D show a larger number of wove bone formation. The new wove bone formation in defect areas in group C was lager than D. The mechanical examination revealed ultimate strength at 12 weeks were group D>group C>group B>group A(P<0.05).Conclusion: Scaffold of n-HA/PLGA and β-TCP/PLGA incorporation with HBO and BMSCs were effective to treat seawater immersed bone defect, and n-HA/PLGA was more excellent than β-TCP/PLGA.


2011 ◽  
Vol 56 (No. 12) ◽  
pp. 595-601 ◽  
Author(s):  
MA Cetinkaya ◽  
B. Yardimci ◽  
C. Yardimci

This paper reviews hypertrophic osteopathy and describes one case report. Hypertrophic osteopathy is a rare pathologic disease process and is observed secondary to a mass in the thorax. In response to the presence of a mass(es), nonoedematous soft tissue swellings and a diffuse periosteal new bone formation develop in all four limbs. The result is mild to severe lameness. A twelve-year-old sexually intact female Cocker spaniel had undergone radical mastectomy on both sides in another veterinary hospital about two years before presentation in our hospital with lameness of both hind limbs. Pain and soft tissue swelling on the distal parts of extremities were determined in clinical examinations. Radiographs revealed periosteal new bone formation on all the long bones of all four limbs, pelvis and sternum; additionally, intrathoracic masses were observed. Euthanasia was performed five months later. Macroscopic examinations of the lungs revealed diffuse and exuberant masses with grizzled whitish cross-sectional colour and with necrotic and haemorrhagic foci. The radius-ulna, tibia, metacarpal and metatarsal bones of both limbs were examined and collected after the necropsy examination. Bone specimens were thicker and the outer surfaces seemed to be rough. At the histopathologic examination of the lung tissue, ovoid or round shaped and hyperchromatic nucleated diffuse anaplastic mammary gland epithelial cells were observed. According to these findings, these masses were diagnosed as the metastasis of malignant mixed tumours. &nbsp;


1983 ◽  
Vol 97 (5) ◽  
pp. 393-398 ◽  
Author(s):  
Kauko Ojala ◽  
Reijo Lahti ◽  
Antti Palva ◽  
Martti Sorri

AbstractThis study consisted of the evaluation of the plain X-ray findings of films taken at early follow-up (mean 1.5 months after surgery) and at late follow-up(4–14 years after the early films) of 211 ears which had been operated on radically and obliterated. Residual cells which were detected on the basis of the early films were associated with a more frequent occurrence of post-operative infection and were thus hallmarks of a poorer prognosis. Changes in the bone surrounding the surgical cavity and the radiological quality of the walls of the surgical cavity, the presence of new bone formation in the cavity and other radiological features did not yield useful information about post-operative complications. New bone formation was associated with a smaller amount of post-operative cavitation. Post-operative X-ray examination of the obliterated ear is a prognostically useful examination, but it does not significantly contribute further to the information available by clinical and otomicroscopic examination in regards to the complications of infection and cholesteatoma.


1987 ◽  
Vol 110 ◽  
Author(s):  
Stephen A. Fredette ◽  
Jacob S. Hanker ◽  
Bill C. Terry ◽  
Beverly L. Giammara

AbstractRepair was compared in 4.4mm experimental rat mandibular ramus defects implanted with dense or porous HA particles with or without a plaster binder. Animals were sacrificed 6 months postimplantation. Specimens underwent gross, radiographic, histochemical and X-ray microanalytical examination. Gross and radiographic examinations showed good particle containment or retention only in defects filled with implants containing plaster. Only porous HA/plaster filled defects showed bone formation throughout the implant when examined histochemically by the PATS reaction and by X-ray microanalysis. They also showed greater radiographic opacity compared to dense HA/plaster implants. Only porous HA/plaster implants showed macroscopic bone formation. Examination of defects filled with porous HA/plaster or porous HA alone by the PATS reaction showed new cancellous bone around, and through the pores of, retained particles. The dense HA/plaster implants showed some new bone around the rims of the defects with only occasional bony incorporation of an HA particle. Dense particles in other areas showed only soft tissue encapsulation. Defects implanted with dense HA without plaster showed no new bone formation but retained particles were incorporated by fibrovascular tissue.


2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Clara De simone ◽  
Giacomo Caldarola ◽  
Magda D'Agostino ◽  
Angelo Carbone ◽  
Cristina Guerriero ◽  
...  

Background. Given that clinical evaluation may underestimate the joint damage and that early treatment can slow down psoriatic arthritis (PsA) progression, screening psoriasis patients with imaging tools that can depict early PsA changes would entail clear benefits.Objective. To compare the ability of X-ray and ultrasound (US) examination in detecting morphological abnormalities consistent with early PsA in patients with psoriasis, using rheumatological evaluation as the gold standard for diagnosis.Methods. Patients with chronic plaque psoriasis and no previous PsA diagnosis attending our outpatient dermatology clinic and reporting finger/toe joint and/or tendon pain underwent X-ray and US evaluation; they were subsequently referred to a rheumatologist for clinical examination and review of imaging findings.Results. Abnormal US and/or X-ray findings involving at least one finger and/or toe (joints and/or tendons) were seen in 36/52 patients: 11 had one or more X-ray abnormalities, including erosion, joint space narrowing, new bone formation, periarticular soft tissue swelling, and periarticular osteoporosis; 36 had suspicious changes on US.Conclusion. US proved valuable in detecting joint and/or tendon abnormalities in the fingers and toes of patients with suspicious changes. The dermatologist should consider US to obtain an accurate assessment of suspicious findings.


2014 ◽  
Vol 41 (6) ◽  
pp. 1218-1219 ◽  
Author(s):  
Georg Schett

The simultaneous presence of bone erosions and bony spurs (osteophytes, enthesophytes) in the joints of patients with psoriatic arthritis (PsA) suggests that the disease leads to enhanced bone resorption as well as increased bone formation, the latter of which has not been observed in patients with rheumatoid arthritis. At the 2013 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members heard an update on the current research into the cytokine signature in PsA and its effects on new bone formation.


2020 ◽  
Author(s):  
gan zhang ◽  
Xiaosong Chen ◽  
Xunsheng Cheng ◽  
Xiuwu Ma ◽  
Congcong Chen

Abstract Introduction: The experiment was undertaken to estimate the effect of BMSCs seeding in different scaffold incorporation with HBO on the repair of seawater immersed bone defect. And future compared n-HA/PLGA with β-TCP/PLGA as scaffold in treatment effect of seawater immersed bone defect.Methods: 60 New Zealand White rabbits with standard seawater defect in radius were randomly divided to group A (implant with nothing), group B (implanted with atuogenous bone), group C (implanted with n-HA/PLGA/BMSCs, and Group D ( implanted with β-TCP/PLGA/BMSCs). After implant, each rabbit receive HBO treatment at 2.4 ATA 100% oxygen for 120 minutes per day for 2 weeeks. Radiograph, histological and biomechanical examination were used to analyze osteogenesis.Result: X-ray analysis show that n-HA/PLGA/BMSCs and β-TCP/PLGA/BMSCs could accelerate the new bone formation, and the new bone formation in group C was lager than in group D or group A, and close to group B (P<0.05). After 12 weeks, in group A, defect without scaffold show a loose connect tissue filled in the areas. The medullary canal in group B was recanalizated. Defect in group C and D show a larger number of wove bone formation. The new wove bone formation in defect areas in group C was lager than D. The mechanical examination revealed ultimate strength at 12 weeks were group D>group C>group B>group A(P<0.05).Conclusion: Scaffold of n-HA/PLGA and β-TCP/PLGA incorporation with HBO and BMSCs were effective to treat seawater immersed bone defect, and n-HA/PLGA was more excellent than β-TCP/PLGA.


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