nach oben

21.03.2024 | Review

From Psoriasis to Psoriatic Arthritis: Ultrasound Insights Connecting Psoriasis with Subclinical Musculoskeletal Inflammation and the Path to Psoriatic Arthritis

verfasst von: A. L. Ribeiro, L. Eder

Erschienen in: Current Rheumatology Reports

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

This review summarizes the literature about the transition from psoriasis to psoriatic arthritis (PsA), focusing on musculoskeletal ultrasound (MSUS) for detecting subclinical inflammation and its role in diagnosis and triage of high-risk patients.

Recent Findings

MSUS effectively detects subclinical musculoskeletal inflammation in patients with psoriasis; however, some of these lesions are non-specific and can be found in healthy individuals. Preliminary evidence suggest that subclinical sonographic findings may predict progression to PsA in psoriasis patients. MSUS can also improve referrals’ accuracy and its integration in the PsA classification criteria may improve early PsA detection.

Summary

MSUS is a valuable tool for detecting subclinical abnormalities in psoriasis patients, which indicate an increased likelihood of progressing to PsA. Its integration into referral protocols and clinical use could improve PsA diagnosis. We propose an MSUS-inclusive algorithm for PsA referrals and triage, which requires validation. The potential of early intervention in reducing PsA progression in psoriasis patients with subclinical inflammation remains to be established.

Armstrong AW, Mehta MD, Schupp CW, Gondo GC, Bell SJ, Griffiths CEM. Psoriasis prevalence in adults in the United States. JAMA Dermatol. 2021;157:940–6.PubMedCrossRef

Mease PJ, Gladman DD, Papp KA, Khraishi MM, Thaçi D, Behrens F, et al. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. J Am Acad Dermatol. 2013;69:729–35.PubMedCrossRef

Mease PJ, Armstrong AW. Managing patients with psoriatic disease: the diagnosis and pharmacologic treatment of psoriatic arthritis in patients with psoriasis. Drugs. 2014;74:423–41.PubMedPubMedCentralCrossRef

Eder L, Chandran V, Shen H, Cook RJ, Shanmugarajah S, Rosen CF, et al. Incidence of arthritis in a prospective cohort of psoriasis patients. Arthritis Care Res (Hoboken). 2011;63:619–22.PubMedCrossRef

Villani AP, Rouzaud M, Sevrain M, Barnetche T, Paul C, Richard M-A, et al. Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: systematic review and meta-analysis. J Am Acad Dermatol. 2015;73:242–8.PubMedCrossRef

Haroon M, Gallagher P, FitzGerald O. Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis. Ann rheumatic diseases. 2015;74:1045–50.CrossRef

Tillett W, Jadon D, Shaddick G, Cavill C, Korendowych E, de Vries CS, et al. Smoking and delay to diagnosis are associated with poorer functional outcome in psoriatic arthritis. Ann Rheum Dis. 2013;72:1358–61.PubMedCrossRef

Gladman DD, Thavaneswaran A, Chandran V, Cook RJ. Do patients with psoriatic arthritis who present early fare better than those presenting later in the disease? Ann Rheum Dis. 2011;70:2152–4.PubMedCrossRef

Kirkham B, de Vlam K, Li W, Boggs R, Mallbris L, Nab HW, et al. Early treatment of psoriatic arthritis is associated with improved patient-reported outcomes: findings from the etanercept PRESTA trial. Clin Exp Rheumatol. 2015;33:11–9.PubMed

10.

Theander E, Husmark T, Alenius G-M, Larsson PT, Teleman A, Geijer M, et al. Early psoriatic arthritis: short symptom duration, male gender and preserved physical functioning at presentation predict favourable outcome at 5-year follow-up. Results from the Swedish Early Psoriatic Arthritis Register (SwePsA). Ann Rheum Dis. 2014;73:407–13.PubMedCrossRef

11.

Punzi L, Podswiadek M, Oliviero F, Lonigro A, Modesti V, Ramonda R, et al. Laboratory findings in psoriatic arthritis. Reumatismo. 2007;59(Suppl 1):52–5.PubMed

12.

Abji F, Pollock RA, Liang K, Chandran V, Gladman DD. Brief report: CXCL10 is a possible biomarker for the development of psoriatic arthritis among patients with psoriasis. Arthritis Rheumatol. 2016;68:2911–6.PubMedCrossRef

13.

Abji F, Lee K-A, Pollock RA, Machhar R, Cook RJ, Chandran V, Gladman DD. Declining levels of CXCL10 over time as a marker for arthritis development in patients with psoriasis. British J Dermatol. 2020;183:e154.

14.

Tom BDM, Chandran V, Farewell VT, Rosen CF, Gladman DD. Validation of the Toronto Psoriatic Arthritis Screen Version 2 (ToPAS 2). J Rheumatol. 2015;42:841–6.PubMedCrossRef

15.

Karreman MC, Weel AEAM, van der Ven M, Vis M, Tchetverikov I, Nijsten TEC, et al. Performance of screening tools for psoriatic arthritis: a cross-sectional study in primary care. Rheumatol. 2017;56:597–602.

16.

Rahmati S, Li Q, Rahman P, Chandran V. Insights into the pathogenesis of psoriatic arthritis from genetic studies. Semin Immunopathol. 2021;43:221–34.PubMedCrossRef

17.

Karason A, Love TJ, Gudbjornsson B. A strong heritability of psoriatic arthritis over four generations--the Reykjavik Psoriatic Arthritis Study. Rheumatol(Oxford). 2009;48:1424–8.CrossRef

18.

Eder L, Chandran V, Pellet F, Shanmugarajah S, Rosen CF, Bull SB, et al. Human leucocyte antigen risk alleles for psoriatic arthritis among patients with psoriasis. Ann Rheum Dis. 2012;71:50–5.PubMedCrossRef

19.

Winchester R, Minevich G, Steshenko V, Kirby B, Kane D, Greenberg DA, et al. HLA associations reveal genetic heterogeneity in psoriatic arthritis and in the psoriasis phenotype. Arthritis Rheum. 2012;64:1134–44.PubMedCrossRef

20.

Pattison E, Harrison BJ, Griffiths CEM, Silman AJ, Bruce IN. Environmental risk factors for the development of psoriatic arthritis: results from a case-control study. Ann Rheum Dis. 2008;67:672–6.PubMedCrossRef

21.

Eder L, Law T, Chandran V, Shanmugarajah S, Shen H, Rosen CF, et al. Association between environmental factors and onset of psoriatic arthritis in patients with psoriasis. Arthritis Care Res (Hoboken). 2011;63:1091–7.PubMedCrossRef

22.

Eder L, Polachek A, Rosen CF, Chandran V, Cook R, Gladman DD. The development of psoriatic arthritis in patients with psoriasis is preceded by a period of nonspecific musculoskeletal symptoms: a prospective cohort study. Arthritis Rheumatol. 2017;69:622–9.PubMedCrossRef

23.

McGonagle D, Gibbon W, Emery P. Classification of inflammatory arthritis by enthesitis. Lancet. 1998;352:1137–40.PubMedCrossRef

24.

McGonagle D, Lories RJ, Tan AL, Benjamin M. The concept of a “synovio-entheseal complex” and its implications for understanding joint inflammation and damage in psoriatic arthritis and beyond. Arthritis Rheum. 2007;56(8):2482–91. https://doi.org/10.1002/art.22758

25.

Kaeley GS, Eder L, Aydin SZ, Gutierrez M, Bakewell C. Enthesitis: a hallmark of psoriatic arthritis. Sem Arthrit Rheumatism. 2018;48:35–43.CrossRef

26.

^• Perez-Chada LM, Haberman RH, Chandran V, Rosen CF, Ritchlin C, Eder L, et al. Consensus terminology for preclinical phases of psoriatic arthritis for use in research studies: results from a Delphi consensus study. Nat Rev Rheumatol. 2021;17:238–43. The initial endeavor in trying to define the preclinical phases that occurs in psoriasis and that might precede the development of PsA.PubMedPubMedCentralCrossRef

27.

Eder L, Tu K, Rosen CF, Alhusayen R, Cheng SY, Young J, et al. Health care utilization for musculoskeletal issues during the prediagnosis period in psoriatic arthritis: a population-based study. Arthritis Care Res (Hoboken). 2021;73:680–6.PubMedCrossRef

28.

D’Agostino M-A, Terslev L, Aegerter P, Backhaus M, Balint P, Bruyn GA, et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 1: definition and development of a standardised, consensus-based scoring system. RMD Open. 2017;3:e000428.PubMedPubMedCentralCrossRef

29.

Balint PV, Terslev L, Aegerter P, Bruyn GAW, Chary-Valckenaere I, Gandjbakhch F, et al. Reliability of a consensus-based ultrasound definition and scoring for enthesitis in spondyloarthritis and psoriatic arthritis: an OMERACT US initiative. Ann Rheum Dis. 2018;77:1730–5.PubMedCrossRef

30.

Bruyn GA, Iagnocco A, Naredo E, Balint PV, Gutierrez M, Hammer HB, et al. OMERACT definitions for ultrasonographic pathologies and elementary lesions of rheumatic disorders 15 years on. J Rheumatol. 2019;46:1388–93.PubMedCrossRef

31.

Gutierrez M, Filippucci E, Salaffi F, Di Geso L, Grassi W. Differential diagnosis between rheumatoid arthritis and psoriatic arthritis: the value of ultrasound findings at metacarpophalangeal joints level. Ann Rheum Dis. 2011;70:1111–4.PubMedCrossRef

32.

Balint PV, Kane D, Wilson H, McInnes IB, Sturrock RD. Ultrasonography of entheseal insertions in the lower limb in spondyloarthropathy. Ann Rheum Dis. 2002;61:905–10.PubMedPubMedCentralCrossRef

33.

^• Gisondi P, Tinazzi I, El-Dalati G, Gallo M, Biasi D, Barbara LM, et al. Lower limb enthesopathy in patients with psoriasis without clinical signs of arthropathy: a hospital-based case-control study. Ann Rheum Dis. 2008;67:26–30. The first study to demonstrate a higher prevalence of sonographic enthesitis in psoriasis patients.PubMedCrossRef

34.

Gutierrez M, Filippucci E, De Angelis R, Salaffi F, Filosa G, Ruta S, et al. Subclinical entheseal involvement in patients with psoriasis: an ultrasound study. Semin Arthritis Rheum. 2011;40:407–12.PubMedCrossRef

35.

Naredo E, Möller I, de Miguel E, Batlle-Gualda E, Acebes C, Brito E, et al. High prevalence of ultrasonographic synovitis and enthesopathy in patients with psoriasis without psoriatic arthritis: a prospective case-control study. Rheumatology (Oxford). 2011;50:1838–48.PubMedCrossRef

36.

Zuliani F, Zabotti A, Errichetti E, Tinazzi I, Zanetti A, Carrara G, et al. Ultrasonographic detection of subclinical enthesitis and synovitis: a possible stratification of psoriatic patients without clinical musculoskeletal involvement. Clin Exp Rheumatol. 2019;37:593–9.PubMed

37.

Aydin SZ, Ash ZR, Tinazzi I, Castillo-Gallego C, Kwok C, Wilson C, et al. The link between enthesitis and arthritis in psoriatic arthritis: a switch to a vascular phenotype at insertions may play a role in arthritis development. Ann Rheum Dis. 2013;72:992–5.PubMedCrossRef

38.

^• Eder L, Jayakar J, Thavaneswaran A, Haddad A, Chandran V, Salonen D, et al. Is the MAdrid Sonographic Enthesitis Index useful for differentiating psoriatic arthritis from psoriasis alone and healthy controls? J Rheumatol. 2014;41:466–72. Key study that found different MASEI scores among PsA, psoriasis patients, and controls, and that emphasized the importance of contextual factors when interpreting sonographic findings.PubMedCrossRef

39.

Ash ZR, Tinazzi I, Gallego CC, Kwok C, Wilson C, Goodfield M, et al. Psoriasis patients with nail disease have a greater magnitude of underlying systemic subclinical enthesopathy than those with normal nails. Ann Rheum Dis. 2012;71:553–6.PubMedCrossRef

40.

Vyas K, Jain SK, Mittal A, Kumar R, Saxena S, Malviya S. Sonographic evaluation of subclinical enthesopathy in patients of chronic plaque psoriasis. Indian Dermatol Online J. 2020;11:580–5.PubMedPubMedCentralCrossRef

41.

Acquacalda E, Albert C, Montaudie H, Fontas E, Danre A, Roux CH, et al. Ultrasound study of entheses in psoriasis patients with or without musculoskeletal symptoms: a prospective study. Joint Bone Spine. 2015;82:267–71.PubMedCrossRef

42.

de Miguel E, Cobo T, Muñoz-Fernández S, Naredo E, Usón J, Acebes JC, et al. Validity of enthesis ultrasound assessment in spondyloarthropathy. Ann Rheum Dis. 2009;68:169–74.PubMedCrossRef

43.

Wilson FC, Icen M, Crowson CS, McEvoy MT, Gabriel SE, Kremers HM. Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis Rheum. 2009;61:233–9.PubMedPubMedCentralCrossRef

44.

Moya Alvarado P, Roé Crespo E, Muñoz-Garza FZ, López-Ferrer A, Laiz Alonso A, Vilarrassa Rull E, et al. 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. J Europ Academ Dermatol Venereol. 2018;32:1728–36.CrossRef

45.

Acosta-Felquer ML, Ruta S, Rosa J, Marin J, Ferreyra-Garrot L, Galimberti ML, et al. Ultrasound entheseal abnormalities at the distal interphalangeal joints and clinical nail involvement in patients with psoriasis and psoriatic arthritis, supporting the nail-enthesitis theory. Semin Arthritis Rheum. 2017;47:338–42.PubMedCrossRef

46.

Castellanos-González M, Joven BE, Sánchez J, Andrés-Esteban EM, Vanaclocha-Sebastián F, Romero PO, et al. Nail involvement can predict enthesopathy in patients with psoriasis. J Dtsch Dermatol Ges. 2016;14:1102–7.PubMedCrossRef

47.

Krajewska-Włodarczyk M, Owczarczyk-Saczonek A, Placek W, Wojtkiewicz M, Wiktorowicz A, Wojtkiewicz J. Distal interphalangeal joint extensor tendon enthesopathy in patients with nail psoriasis. Sci Rep. 2019;9:3628.PubMedPubMedCentralCrossRef

48.

Bakirci S, Solmaz D, Stephenson W, Eder L, Roth J, Aydin SZ. Entheseal changes in response to age, body mass index, and physical activity: an ultrasound study in healthy people. J Rheumatol. 2020;47:968–72.PubMedCrossRef

49.

Moshrif A, Abdel Noor R, Aly H, Mortada M, Hafez A. Aging and entheses: an ultrasonographic probing of degenerative enthesopathy in a cohort of 147 healthy subjects. Int J Rheumat Diseases. 2022;25:481–8.CrossRef

50.

Michelsen B, Diamantopoulos AP, Soldal DM, Hammer HB, Kavanaugh A, Haugeberg G. Achilles enthesitis defined by ultrasound is not associated with clinical enthesitis in patients with psoriatic arthritis. RMD Open. 2017;3:e000486.PubMedPubMedCentralCrossRef

51.

Tinazzi I, McGonagle D, Biasi D, Confente S, Caimmi C, Girolomoni G, et al. Preliminary evidence that subclinical enthesopathy may predict psoriatic arthritis in patients with psoriasis. J Rheumatol. 2011;38:2691–2.PubMedCrossRef

52.

Elnady B, El Shaarawy NK, Dawoud NM, Elkhouly T, Desouky DE-S, ElShafey EN, et al. Subclinical synovitis and enthesitis in psoriasis patients and controls by ultrasonography in Saudi Arabia; incidence of psoriatic arthritis during two years. Clin Rheumatol. 2019;38:1627–35.PubMedCrossRef

53.

^•• Zabotti A, McGonagle DG, Giovannini I, Errichetti E, Zuliani F, Zanetti A, et al. Transition phase towards psoriatic arthritis: clinical and ultrasonographic characterisation of psoriatic arthralgia. RMD Open. 2019;5:e001067. Pivotal study linking sonographic findings with progression from psoriasis to PsA.PubMedPubMedCentralCrossRef

54.

Faustini F, Simon D, Oliveira I, Kleyer A, Haschka J, Englbrecht M, et al. Subclinical joint inflammation in patients with psoriasis without concomitant psoriatic arthritis: a cross-sectional and longitudinal analysis. Ann Rheum Dis. 2016;75:2068–74.PubMedCrossRef

55.

Simon D, Tascilar K, Kleyer A, Bayat S, Kampylafka E, Sokolova MV, et al. Association of structural entheseal lesions with an increased risk of progression from psoriasis to psoriatic arthritis. Arthritis Rheumatol. 2022;74:253–62.PubMedCrossRef

56.

^•• Savage L, Goodfield M, Horton L, Watad A, Hensor E, Emery P, et al. Regression of peripheral subclinical enthesopathy in therapy-naive patients treated with ustekinumab for moderate-to-severe chronic plaque psoriasis: a fifty-two-week, prospective, open-label feasibility study. Arthritis Rheumatol. 2019;71:626–31. First study using ultrasound to identify subclinical inflammation in psoriasis patients as an inclusion criterion and as a primary endpoint for biological treatment.PubMedCrossRef

57.

Kampylafka E, Simon D, d’Oliveira I, Linz C, Lerchen V, Englbrecht M, et al. Disease interception with interleukin-17 inhibition in high-risk psoriasis patients with subclinical joint inflammation—data from the prospective IVEPSA study. Arthrit Res Therapy. 2019;21:178.CrossRef

58.

Sarabia S, Farrer C, Yeung J, Jerome D, Cook RJ, Eder L. Comparative efficacy of different triage methods for psoriatic arthritis: results from a prospective study in a rapid access clinic. Arthrit Care Res. 2022;74:1254–62.CrossRef

59.

Solmaz D, Bakirci S, Al Onazi A, Al Osaimi N, Fahim S, Aydin SZ. Musculoskeletal ultrasound can improve referrals from dermatology to rheumatology for patients with psoriasis. Br J Dermatol. 2020;182:804–6.PubMedCrossRef

60.

Grobelski J, Wilsmann-Theis D, Karakostas P, Behning C, Brossart P, Schäfer VS. Prospective double-blind study on the value of musculoskeletal ultrasound by dermatologists as a screening instrument for psoriatic arthritis. Rheumatology (Oxford). 2023;62:2724–31.PubMedCrossRef

61.

Sarabia S, Farrer C, Yeung J, Jerome D, Lee K-A, Cook R, et al. The pattern of musculoskeletal complaints in patients with suspected psoriatic arthritis and their correlation with physical examination and ultrasound. J Rheumatol. 2021;48:214–21.PubMedCrossRef

62.

Grobelski J, Recker F, Wilsmann-Theis D, Hartung W, Karakostas P, Brossart P, et al. Establishment and validation of a didactic musculoskeletal ultrasound course for dermatologists using an innovative handheld ultrasound system - the MUDE study (Musculoskeletal Ultrasound in Dermatology). J Dtsch Dermatol Ges. 2021;19:1753–9.PubMed

63.

Bakewell C, Aydin SZ, Ranganath VK, Eder L, Kaeley GS. Imaging techniques: options for the diagnosis and monitoring of treatment of enthesitis in psoriatic arthritis. J Rheumatol. 2020;47:973–82.PubMedCrossRef

64.

Kaeley GS, Eder L, Aydin SZ. Developing ultrasound measures for the early diagnosis of psoriatic arthritis. J Rheumatol. 2023;50(Suppl 2):51–52. https://doi.org/10.3899/jrheum.2023-0529

65.

Singla S, Eder L, Kaeley G, Aydin SZ. The use and availability of musculoskeletal ultrasonography for psoriatic disease among group for research and assessment of psoriasis and psoriatic arthritis members and the unmet needs. Clin Ther. 2023;S0149-2918(23):00199–6.

66.

^•• Felbo SK, Terslev L, Juul Sørensen I, Hendricks O, Kuettel D, Lederballe Pedersen R, et al. Musculoskeletal pain in psoriasis-relation to inflammation and additional value of ultrasound in psoriatic arthritis classification. Rheumatology (Oxford). 2022;61:2835–47. Innovative study incorporating ultrasound findings in CASPAR criteria to enhance its sensitivity.PubMedCrossRef

67.

Eder L, Kaeley GS, Aydin SZ. Development and validation of a sonographic enthesitis instrument in psoriatic arthritis: the GRAPPA Diagnostic Ultrasound Enthesitis Tool (DUET) Project. J Rheumatol Suppl. 2020;96:50–2.PubMedCrossRef

68.

Aydin SZ, Eder L, Kaeley GS. Toward a Sonographic Composite Index for diagnosis in psoriatic arthritis: highlights from the GRAPPA Ultrasound Workshop. J Rheumatol. 2022;49:67–71.PubMed

69.

^•• Tom S, Zhong Y, Cook R, Aydin SZ, Kaeley G, Eder L. Development of a preliminary ultrasonographic enthesitis score in psoriatic arthritis - GRAPPA ultrasound working group. J Rheumatol. 2019;46:384–90. Pilot study informing the DUET project, in which the diagnostic relevance of certain entheseal sites for ultrasound assessment were reviewed.PubMedCrossRef

70.

Zabotti A, De Marco G, Gossec L, Baraliakos X, Aletaha D, Iagnocco A, et al. EULAR points to consider for the definition of clinical and imaging features suspicious for progression from psoriasis to psoriatic arthritis. Ann Rheum Dis. 2023;82:1162–70.PubMed

71.

Marco GD, Zabotti A, Baraliakos X, Iagnocco A, Aletaha D, Gisondi P, et al. Characterisation of prodromal and very early psoriatic arthritis: a systematic literature review informing a EULAR taskforce. RMD Open. 2023;9:e003143.PubMedPubMedCentralCrossRef

72.

Solmaz D, Ehlebracht A, Karsh J, Bakirci S, McGonagle D, Aydin SZ. Evidence that systemic therapies for psoriasis may reduce psoriatic arthritis occurrence. Clin Exp Rheumatol. 2020;38:257–61.PubMedCrossRef

73.

Gisondi P, Bellinato F, Targher G, Idolazzi L, Girolomoni G. Biological disease-modifying antirheumatic drugs may mitigate the risk of psoriatic arthritis in patients with chronic plaque psoriasis. Ann Rheum Dis. 2022;81:68–73.PubMedCrossRef

74.

Acosta Felquer ML, LoGiudice L, Galimberti ML, Rosa J, Mazzuoccolo L, Soriano ER. Treating the skin with biologics in patients with psoriasis decreases the incidence of psoriatic arthritis. Ann Rheum Dis. 2022;81:74–9.PubMedCrossRef

75.

Rosenthal YS, Schwartz N, Sagy I, Pavlovsky L. Incidence of psoriatic arthritis among patients receiving biologic treatments for psoriasis: a nested case-control study. Arthritis Rheumatol. 2022;74:237–43.PubMedCrossRef

76.

Meer E, Merola JF, Fitzsimmons R, Love TJ, Wang S, Shin D, et al. Does biologic therapy impact the development of PsA among patients with psoriasis? Ann Rheum Dis. 2022;81:80–6.PubMedCrossRef

77.

^• Haberman RH, KA MF, Catron S, Samuels J, Blank RB, Toprover M, et al. Efficacy of guselkumab, a selective IL-23 inhibitor, in preventing arthritis in a multicentre psoriasis at-risk cohort (PAMPA): protocol of a randomised, double-blind, placebo controlled multicentre trial. BMJ Open. 2022;12:e063650. Key trial exploring the prevention of PsA in at-risk psoriasis patients with sonographic findings being required as an inclusion criterion and with sonographic inflammation as a co-primary endpoint.PubMedPubMedCentralCrossRef

78.

Karmacharya P, Wright K, Achenbach SJ, Bekele D, Crowson CS, Ogdie A, et al. Diagnostic delay in psoriatic arthritis: a population based study. J Rheumatol. 2021;48:1410–6.PubMedPubMedCentralCrossRef

79.

Ribeiro AL, Dullius L, Sartori NS, Azeredo-da-Silva A, Kohem CL, Coates L, et al. Challenges in the management of psoriatic arthritis in Latin America: A Systematic Review. Clin Ther. 2023;S0149-2918(23):00134-0.

80.

van Onna M, Gorter S, Maiburg B, Waagenaar G, van Tubergen A. Education improves referral of patients suspected of having spondyloarthritis by general practitioners: a study with unannounced standardised patients in daily practice. RMD Open. 2015;1:e000152.PubMedPubMedCentralCrossRef

81.

FitzGerald O, Pennington SR. HIPPOCRATES: improving diagnosis and outcomes in psoriatic arthritis. Nat Rev Rheumatol. 2022;18:123–4.PubMedCrossRef

82.

Bell S, Merola JF, Webster DE, Pennington SR, Liao W, Ogdie A, et al. Aiming for cure and preventive initiatives in psoriatic disease: building synergy at NPF, GRAPPA, and PPACMAN. Curr Rheumatol Rep. 2020;22:78.PubMedCrossRef

83.

Naredo E, Wakefield RJ, Iagnocco A, Terslev L, Filippucci E, Gandjbakhch F, Aegerter P, Aydin S, Backhaus M, Balint PV, Bruyn GA, Collado P, Finzel S, Freeston JE, Gutierrez M, Joshua F, Jousse-Joulin S, Kane D, Keen HI, et al. The OMERACT ultrasound task force--status and perspectives. J Rheumatol. 2011;38(9):2063–7.PubMedCrossRef

84.

D'Agostino MA, Boers M, Wakefield RJ, Berner Hammer H, Vittecoq O, Filippou G, Balint P, Möller I, Iagnocco A, Naredo E, Østergaard M, Gaillez C, Le Bars M. Exploring a new ultrasound score as a clinical predictive tool in patients with rheumatoid arthritis starting abatacept: results from the APPRAISE study. RMD Open. 2016;2(1):e000237.PubMedPubMedCentralCrossRef

Titel: From Psoriasis to Psoriatic Arthritis: Ultrasound Insights Connecting Psoriasis with Subclinical Musculoskeletal Inflammation and the Path to Psoriatic Arthritis
verfasst von: A. L. Ribeiro
L. Eder
Publikationsdatum: 21.03.2024
Verlag: Springer US
Erschienen in: Current Rheumatology Reports
Print ISSN: 1523-3774
Elektronische ISSN: 1534-6307
DOI: https://doi.org/10.1007/s11926-024-01146-9

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen