Role of musculoskeletal ultrasound, magnetic resonance imaging, and serum chemokine C-X-C motif ligand 10 in early detection of arthritis in patients with psoriasis

Abstract

Aim of the workTo assess the role of musculoskeletal ultrasound (MSUS) and magnetic resonance imaging (MRI) and the following laboratory biomarkers; C-reactive protein (CRP), serum uric acid (SUA) and chemokine C-X-C motif ligand 10 (CXCL-10) in early detection of psoriatic arthritis (PsA) among patients with skin psoriasis (PsO). Patients and methodsA cross-sectional study was performed over 40 psoriatic patients with arthralgia and another 40 without arthralgia. All underwent MSUS of the peripheral joints, entheses, and MRI of sacroiliac joints. Madrid Sonographic Enthesitis Index (MASEI) scores were calculated. Each patient was tested for CRP, SUA, and CXCL-10. ResultsThe 80 patients median age was 46.5 (25) years (19–66 years) and were 44 females and 36 males (F: M 1.2:1) and disease duration of PsO was 4 (10.38) years (0.08–30 years). The CXCL-10 level in all the patients was 552.5 (535) pg/mL (300–1000 pg/mL). 24 (30%) of the patients had early PsA as they had active enthesitis, synovitis or sacroiliitis. 14 (17.5%) had enthesopathy without positive power Doppler (PD) signals. CXCL-10 significantly correlated with tender joint count (p < 0.001), entheseal count (p < 0.001), MASEI inflammatory score (p = 0.02) and inversely with damage score (p = 0.048). It was significantly associated with PsA development. Unlike CRP and SUA, CXCL-10 was highly sensitive (100%) for detecting PsA using a cut-off point of 552.5 pg/mL (p < 0.001). ConclusionsImaging detected PsA and subclinical enthesopathy are common among psoriatic patients. CXCL-10 is associated with abnormal PD findings. It may be a future predictive biomarker for PsA in those patients.