Synovio-Enthesitis on Ultrasound May Detect Subclinical PsA

Ultrasound-detected synovio-enthesitis was significantly associated with subclinical psoriatic arthritis (PsA) in patients with moderate-to-severe psoriasis, according to study findings published online ahead of print in European Radiology.

The multicenter study included 490 patients with moderate-to-severe psoriasis, of whom 384 were without arthritis symptoms (the “silent psoriasis group”) and 106 had arthritis symptoms (the “clinical PsA group”). An additional 80 participants without psoriasis made up a control group. Participants underwent clinical assessments and ultrasound examinations of 60 joints, 38 tendons, and 40 entheses.

Synovio-enthesitis was the only significant difference between the silent psoriasis group and the control group, according to the study. The incidence of synovio-enthesitis was 16.1% in the silent psoriasis group compared with 1.3% in the control group. Synovio-enthesitis occurred in the knee more than three-quarters of the time.

Using synovio-enthesitis as the identification standard, the rate of subclinical PsA in all patients with psoriasis was 12.7%, the study found. Body surface area and Psoriasis Area and Severity Index scores did not differ between patients with psoriasis, subclinical PsA, and prodromal/active PsA.

“Routine ultrasound evaluation could help screen [patients with psoriasis] in the subclinical psoriatic arthritis phase,” wrote the Shanghai, China-based research team, “which was as high as 12.7% in all psoriasis patients.” 

Reference:
Chen ZT, Chen RF, Li XL, et al. The role of ultrasound in screening subclinical psoriatic arthritis in patients with moderate to severe psoriasis. Eur Radiol. Published online February 28, 2023. doi:10.1007/s00330-023-09493-4