Ultrasound and Power Doppler Evaluation of the Distal Interphalangeal Joints in Patients with Psoriatic Arthritis

Abstract

Objective: 1. To evaluate the frequency of the various lesions in distal interphalangeal joints of patients with psoriatic arthritis by clinical and ultrasound assessment. 2. To determine the correlation between grayscale and Power Doppler ultrasonography score with disease activity score. Methods: This cross-sectional study was performed on 41 patients, who were diagnosed with psoriatic arthritis by CASPAR 2006 criteria. Results: Ultrasound detected more joint lesions than clinical examination. The proportion of patients with clinical distal interphalangeal arthritis was 12,2%. 100% of patients had at least one distal interphalangeal arthritis by ultrasound, and 27,6% of patients had periarticular soft tissue lesions. The frequency of various ultrasound abnormalities was as follows: Synovial hypertrophy was seen in 55,9%, Power Doppler abnormality suggesting hypervascularity in 52,5%. The periarticular lesion frequency: extensor tendonitis in 6,1%; loss of normal fibrillary architecture of extensor tendon erosions was seen in 14,4%; flexor tenositis in 7,1%; and other lesions were seen in 32,8% of patients. Significant correlation was found between DAPSA score and grayscale joint count (GSJC) (Spearman’s R=0,55; p[Formula: see text]0,001), grayscale joint score (GSJS) (R=0,62; P<0,001), Power Doppler joint count (PDJC) (R=0.68; p[Formula: see text]0,001), and Power Doppler joint score (PDJS) (R=78; p[Formula: see text]0,001). Conclusion: Ultrasound can detect more joint lesions than clinical assessment. The severity of lesions on ultrasound correlates with the disease activity score.