Resumo

CAZENAVE, Tomás et al. Utility of ultrasonography as a diagnostic tool to detect psoriatic arthritis in patients with psoriasis. Rev. argent. reumatolg. [online]. 2017, vol.28, n.1, pp.17-21. ISSN 0327-4411.

The aim of our study was to evaluate the prevalence of subclinical enthesopathy in patients with psoriasis (Ps) using ultrasound (US) as a diagnostic tool in daily practice and to evaluate the discriminant capacity of the score to differentiate Ps from Psoriatic Arthritis patients (PsA). Material and methods: We included healthy controls (HC) patients with Ps and psoriatic arthritis (PsA). Ten enthesis sites were evaluated: insertion of the quadriceps tendon, proximal and distal insertions of the patellar tendon, Achilles tendon and plantar fascia. The US identified the following findings: tendon thickening, bone erosion, enthesophyte, bursitis and PD signal. The GUESS US score was calculated. The score performance to discriminate between APs and Ps was evaluated using ROC curves. Results: We included 51 subjects: PsA=16, Ps= 15 and CS=20. The mean age was 42±13 years and 39% were women. A total of 510 enthesis (PsA=160, Ps=150, HC=200) were evaluated. Ps patients showed a significantly higher frequency of enthesophytes, erosions and PD than HC. The mean GUESS score was different between groups (mean±SD): PsA=13±4 Ps=8±4 HC=3±2 (p<0.01). The area under the curve (AUC) for the diagnosis of PsA was 0.79 (95% CI=0.63 to 0.95). Conclusions: Patients with Ps showed high frequency of subclinical enthesopathy in the US assessment. The GUESS score showed high sensitivity and moderate specificity to discriminate between patients with PsA and Ps.

Palavras-chave : psoriatic arthritis; ultrasonography.