CLINICAL HETEROGENEITY OF EARLY PSORIATIC ARTHRITIS
https://doi.org/10.14412/1996-7012-2016-4-51-56
Abstract
Objective: to reveal the characteristic symptoms and syndromes of early-stage psoriatic arthritis (ePsA), which are pivotal to its early diagnosis.
Patients and methods. Fifty-one patients with a PsA duration of less than 2 years (mean 12 months) were examined. The diagnosis of PsA was established on the basis of the conventional CASPAR criteria and the Russian criteria developed by the expert method. The conventional current criteria, including the number of tender and swollen joints, DAS28, values of acute-phase indicators, were used to detect inflammatory activity. Skin syndrome was evaluated using the Psoriasis Area and Severity Index (PASI). X-ray study of the hands, distal and proximal feet, pelvis, and other involved joints and MRI of the distal hands/feet were performed. The Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) and reduced GUESS were used to assess enthesopathy.
Results. The types of articular syndrome in ePsA were identified in accordance of the duration of the disease. The authors determined the characteristic features of arthritis, spondylitis, enthesitis, and dactylitis, their diagnostic value and associations with other manifestations in the first 2 years of PsA. There was a relationship of dermatitis and psoriatic onychopathy to the clinical picture of articular syndrome.
Conclusion. ePsA is characterized by marked heterogeneity of articular syndrome with predominantly mono/oligoarthritic and polyarthritic articular syndrome. The significant signs are enthesitis and dactylitis, which serve as risk factors for the unfavorable course of the disease.
About the Authors
V. V. Badokin
Russian Medical Academy of Postgraduate Education
Russian Federation
Russian Federation
Contact: Vladimir Vasilyevich Badokin;RussianMedicalAcademyof Postgraduate Education, Ministry of Health ofRussia, 2/1, Barrikadnaya St.,Moscow123836
I. A. Troshkina
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
References
1. Агабабова ЭР, Бадокин ВВ, Эрдес ШФ и др. Разработка и апробация диагностических критериев псориатического артрита. Терапевтический архив. 1998;12:117-21 [Agababova ER, Badokin VV, Erdes ShF, et al. Development and testing of the diagnostic criteria for psoriatic arthritis. Terapevticheskiy Arkhiv. 1998;12:117-21 (In Russ.)].
2. Бадокин ВВ. Псориатический артрит и псориаз: проблемы взаимосвязи и взаимообусловленности. В кн.: Насонова ВА, Бунчук НВ, редакторы. Избранные лекции по клинической ревматологии. Москва: Медицина; 2001. С. 82-91 [Badokin VV. Psoriatic arthritis and psoriasis: interrelation and interdependence problem. In: Nasonova VA, Bunchuk HB, editors. Izbrannye lektsii po klinicheskoy revmatologii [Selected lectures in clinical rheumatology]. Moscow: Medicine; 2001. P. 82-91].
3. Gladman DD, Brockbank J. Psoriatic arthritis. Expert Opin Investig. Drugs. 2000;9: 1511-22. doi:10.1517/13543784.9.7.1511
4. Roussou EP. Incidence and prevalence of rheumatic condition in south Europe (Halkidiki study). EULAR 2001. Ann Rheum Dis. 2001;60(Suppl):343.
5. Brockbank JE, Schentag C, Rosen C, et al. Psoriatic arthritis (PsA) is common among patients with psoriasis and family medicine clinical attendees. Arthritis Rheum. 2001;44(Suppl):94.
6. O'Neill T, Silman AJ. Psoriatic arthritis. Historical background and epidemiology. Bailliere's Clin Rheumatol. 1994;8:245-61. doi:10.1016/S0950-3579(94)80017-0
7. Moll JM, Wright V. Psoriatic arthritis. Semin Arthritis Rheum. 1973;3:55-78. doi:10.1016/0049-0172(73)90035-8
8. Queiro-Silva R, Torre-Alonso JC, TintureEguren T, Lopez-Lagunas I. A polyarticular onset predicts erosive and deforming disease in psoriatic arthritis. Ann Rheum Dis. 2003;62(1): 68-70. doi:10.1136/ard.62.1.68
9. Scarpa R, Cuocolo A, Peluso R, et al. Early psoriatic arthritis: the clinical spectrum. J Rheumatol. 2008;35(1):137-41.
10. Бадокин ВВ. Псориатический артрит: клиника, диагностика, лечение: Дисс. докт. мед. наук. Москва; 2003. С. 188-97 [Badokin VV. Psoriaticheskiy artrit: klinika, diagnostika, lechenie: Diss. dokt. med. nauk [Psoriatic arthritis: clinical features, diagnosis, treatment: Diss. Doct. med. sci.]. Moscow; 2003. P. 188-97].
11. Helliwell PS, Porter G, Taylor WJ; CASPAR Study Group. Polyarticular psoriatic arthritis is more like oligoarticular psoriatic arthritis, than rheumatoid arthritis. Ann Rheum Dis. 2007;66(1):113-7. doi:10.1136/ard.2006.054288
12. Kane D, Stafford L, FitzGerald B. A classification subsets in an inception cohort of early psoriatic peripheral arthritis – «DIP or not DIP revisited». Rheumatology. 2003;42: 1469-76. doi:10.1093/rheumatology/keg445
13. Gladman DD, Shuckett R, Russell ML, et al. Psoriatic arthritis (PsA) – an analysis of 220 patients. Q J Med. 1987;62:127-41.
14. McGonagle D, Marzo-Ortega H, O'Connor, et al. Histological assessment of the early enthesitis lesion in spondyloarthropathy. Ann Rheum Dis. 2002;61:534-37. doi:10.1136/ard.61.6.534
15. Battistone MJ, Manaster BJ, Reda DJ, Clegg DO. The prevalence of sacroiliitis in psoriatic arthritis: A new perspectives from large, multicenter cohort. A department of Veterans Affairs Cooperative Study. Skeletal Radiol. 1999;28:196-201. doi:10.1007/s002560050500
16. Chandran V, Schentag CT, Gladman DD. Sensitivity of the classification of psoriatic arthritis criteria in early psoriatic arthritis. Arthritis Rheum. 2007;15:1560-63. doi:10.1002/art.23104
17. Kane D, Stafford L, Bresnihan B, FitzGerald O. A prospective, clinical and radiological study of early psoriatic arthritis: an early synovitis clinic experience. Rheumatology (Oxford). 2003;42:1460-8. doi:10.1093/rheumatology/keg384
18. Молочков ВА, Бадокин ВВ, Альбанова ВИ, Волнухин ВА. Псориаз и псориатический артрит. Москва; 2007. С. 197-276 [Molochkov VA, Badokin VV, Albanova VI, Volnukhin VA. Psoriaz i psoriaticheskiy artrit [Psoriasis and psoriatic arthritis]. Moscow; 2007. P. 197-276].
19. Marsal S, Armadans-Gil L. Clinical, radiographic and HLA associations as markers for different patterns of psoriatic arthritis. Rheumatology (Oxford). 1999;38(4):332-7. doi:10.1093/rheumatology/38.4.332
20. Taylor W, Gladman DD, Helliwell PS, et al. CASPAR Study Group. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum. 2006;4(8):2665-73. doi:10.1002/art.21972
21. Heuft-Dorenbosch L, Spoorenberg A, van Tubergen A, et al. Assessment of enthesitis in ankylosing spondylitis. Ann Rheum Dis. 2003;62(2):127-32. doi:10.1136/ard.62.2.127
22. Красненко СО, Логинова ЕЮ, Коротаева ТВ, Смирнов АВ. Сравнительная характеристика данных МРТ, рентгенологических и клинических исследований кистей и стоп у больных ранним псориатическим артритом. Научно-практическая ревматология. 2013; 51(2):149-53 [Krasnenko SO, Loginova EY, Korotaeva TV, Smirnov AV. Comparative characterization of the data of magnetic resonance imaging, X-ray and clinical studies of the hand and foot joints in patients with early psoriatic arthritis. NauchnoPrakticheskaya Revmatologiya = Rheumatology Science and Practice. 2013;51(2):149-53 (In Russ.)]. doi:10.14412/1995-4484-2013-642.
23. Brockbank JE, Stein M, Gladman D. Dactylitis in psoriatic arthritis: a marker for disease severity? Ann Rheum Dis. 2005;64: 188-90. doi: 10.1136/ard.2003.018184
24. Punzi L, Pianon M, Rossini P, et al. Clinical and laboratory manifestations of elderly onset psoriatic arthritis: a comparison with younger onset disease. Ann Rheum Dis. 1999;58:226-9. doi:10.1136/ard.58.4.226
25. Логинова ЕЮ, Коротаева ТВ. Ранний псориатический артрит. Научно-практическая ревматология. 2008;46(6):47-55 [Loginova EY, Korotaeva TV. Early psoriatic arthritis. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2008;46(6):47-55 (In Russ.)]. doi:10.14412/1995-4484-2008-490.
26. Scarpa R, Soscia E, Peluso R, et al. Nail and distal interphalangeal joint in psoriatic arthritis. J Rheumatol. 2006;33(7):1315-9.
27. McGonagle D, Ash Z, Dickie L, et al. The early phase of psoriatic arthritis. Ann Rheum Dis. 2011;70(Suppl 1):71-6. doi:10.1136/ard.2010.144097
28. Balint PV, Kane D, Wilson H, et al. Ultrasonography of entheseal insertions in the lower limb in spondyloarthropathy. Ann Rheum Dis. 2002;61:905-10. doi:10.1136/ard.61.10.905
Review
For citations:
Badokin VV, Troshkina IA. CLINICAL HETEROGENEITY OF EARLY PSORIATIC ARTHRITIS. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2016;10(4):51-56. (In Russ.) https://doi.org/10.14412/1996-7012-2016-4-51-56
Views:
1279
Email this article 