PARIS -- July 7, 2010 -- Patients with plaque-type psoriasis more frequently display pathological findings on power doppler ultrasound examination indicative for synovitis and enthesopathy compared with non-psoriatic patients, suggesting a subclinical musculoskeletal involvement in patients asymptomatic for musculoskeletal disease.
However, ultrasound findings in patients with plaque-type psoriasis without musculoskeletal clinical involvement are not well defined. Findings were presented at the 3rd International Congress on Psoriasis.
"The objective of our study was to investigate the presence of synovitis and enthesitis with power Doppler ultrasonography in patients with psoriasis without symptoms nor clinical signs of musculoskeletal diseases," said lead study author E. Dauden, MD, Dermatology, University Hospital De La Princessa, Madrid, Spain.
A total of 136 patients with plaque psoriasis and 46 age-matched controls with other skin diseases, all withot musculoskeletal diseases were recurited at 14 centres. They underwent dermatological and rheumatological assessment.
For each patient a blinded power doppler ultrasound assessment was performed by the same investigator at each centre.
The results of the assessment consisted of detection of 1 synovitis with synovial PD signal in 36 joints, 1 tenosynovitis detection with tenosynovial PD signal at 22 sites, and 1enthesopathy dectetion with entheseal PD signal in 18 entheses.
The total percentage of joints with synovitis was 2.4% in patients with psoriasis and 1% in controls (P < .0005).
Entesopathy was present in 11.6% of patients with entheses and 5.3% of control entheses (P < .0005)
While no patients in the control group showed entheseal PD signal, 7.4% of patients with psoriasis did show this finding (P = .05).
Among all the clinical and demographic data, the only significantly predictive factor of pathological PDUS finding was psoriasis.
"We found synovitis and enthesopathy were significantly more frequent in psoriasis patients than in controls," said Dr. Dauden. "This finding may indicate a subclinical musculoskeletal involvement."
SOURCE: 3rd International Congress on Psoriasis
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