Early psoriatic arthritis: the clinical spectrum(410 views) Scarpa R, Cuocolo A, Peluso R, Atteno M, Gisonni P, Iervolino S, Di Minno MND, Nicolai E, Salvatore M, Del Puente A
The Journal Of Rheumatology (ISSN: 0315-162x), 2008 Jan; 35(1): 137-141.
Department of Clinical and Experimental Medicine, Early Psoriatic Arthritis Clinic, Rheumatology Research Unit, University Federico II, Naples, Italy. rscarpa@unina.it
Department of Biomorphological and Functional Sciences, University Federico II, Naples, Italy
SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy
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Early psoriatic arthritis: the clinical spectrum
OBJECTIVE: To characterize the clinical pattern of early psoriatic arthritis (PsA).; METHODS: We studied 47 consecutive patients: 29 had definite PsA and 18 had the "sine psoriasis" subset. Inclusion criteria were articular and/or entheseal involvement of < or =12 weeks' duration and the exclusive use, before enrollment, of nonsteroidal antiinflammatory drugs to control articular symptoms. All patients underwent clinical examination, blood tests, total-body bone scintigraphy, articular ultrasonography, and radiography of clinically involved joints and/or entheses.; RESULTS: On the basis of clinical examination, early PsA was an oligo-enthesoarthritis in over 75% of patients studied. In contrast, the number of joints and/or entheses showing increased tracer uptake on bone scintigraphy was 3 times greater, compared to the clinical evidence (p < 0.001). Articular ultrasonography confirmed the inflammatory involvement of synovium and/or entheses in all articular sites active at time of bone scintigraphy, but silent at clinical examination. In addition, 7 patients showed the occurrence of joint and/or entheseal erosions on standard radiography.; CONCLUSION: Bone scintigraphy yields a more accurate evaluation of entheso-articular involvement and distribution in patients with early PsA. Our results suggest that clinical oligo-enthesoarthritic presentation of early PsA might represent in most cases a polyarticular condition that is at increased risk for clinical progression. These findings have a significant influence on the clinical decision-making process in patients with early PsA.
Hesse B, Tagil K, Cuocolo A, Anagnostopoulos C, Bardies M, Bax J, Bengel F, Busemann Sokole E, Davies G, Dondi M, Edenbrandt L, Franken P, Kjaer A, Knuuti J, Lassmann M, Ljungberg M, Marcassa C, Marie PY, Mckiddie F, O'connor M, Prvuolovich E, Underwood R * 3. 0 T perfusion MR imaging(694 views) Rivista Di Neuroradiologia (ISSN: 1120-9976), 2004; 17(6): 807-812. Impact Factor:0.023 ViewExport to BibTeXExport to EndNote