Evaluation of shear wave elastography and B-mod ultrasonography of the achilles tendons in psoriasis patients without clinical diagnosis of psoriatic arthritis

Abstract

AIM

To investigate the utility of shear wave elastography (SWE) and conventional ultrasonography (B-mode and Power Doppler) (CUS) as imaging modalities to detect subclinical enthesopathy in early psoriatic arthritis (PsA).

MATERIALS AND METHODS

This study involved controls and patients with psoriasis who did not have a diagnosis of psoriatic arthritis. This study was conducted prospectively between January 2021 and June 2021 in a single centre. Age, gender, Psoriasis Area Severity Index (PASI) of the patients was recorded. CUS findings (thickness, contour change, hypoechoic heterogeneity, effusions, enthesophyte, bursitis, bone erosion, and increased tendon vascularity) of the Achilles tendons (ATs) were evaluated. Subsequently, SWE measurements in kilopascals (kPa) were conducted at the enthesis sites of the tendons.

RESULTS

The ATs of each of the 62 participants (31 patients and 31 controls) were evaluated. The mean age of the patients was 44.96 ± 17.44 years with a female dominance. The stiffness of the AT was significantly higher than the controls (p < 0.05). There were no statistically significant differences in AT thicknesses between the groups (p > 0.05). No significant correlation was found between the SWE of AT and PASI scores (p > 0.05, r = 0.1).

CONCLUSION

This study found that although CUS did not show any significant findings, the tendons of patients with psoriasis without musculoskeletal symptoms were statistically significantly stiffer according to SWE values compared to controls. These results suggest that SWE may be more effective than CUS in detecting subclinical enthesopathy and predicting the development of PsA in patients with psoriasis.