Ultrasonographic evaluation of nail involvement in psoriatic arthritis: A systematic review and meta-analysis

IF 0.5 Q3 Health Professions

Revista Colombiana de Reumatologia Pub Date : 2026-04-01 Epub Date: 2026-02-07 DOI:10.1016/j.rcreu.2026.504877

Jairo Cajamarca-Barona , Catalina Sanmiguel-Reyes , Jhon Buitrago , Laura Gallego , Diana Guavita-Navarro , Jose Yate , Ana María Arredondo , Hector Cubides , Alejandro Escobar , Adriana Rojas-Villarraga , Diego Javier Martínez Lozano

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引用次数: 0

Abstract

Introduction and objective

Nail involvement is a hallmark of psoriatic arthritis (PsA), often reflecting disease severity and systemic inflammation. Subclinical nail changes frequently precede joint symptoms, making early detection essential for timely intervention. Ultrasonography, with its high-frequency probes and power Doppler technology, provides a non-invasive method to assess nail structures and inflammatory activity. Our systematic review and meta-analysis concentrate on the role of ultrasound (US) in identifying subclinical or early PsA-related nail changes – particularly nail plate and nail bed thickness.

Materials and methods

A systematic review and meta-analysis were conducted following the PRISMA guidelines. Nine studies were included for qualitative synthesis, and three studies for quantitative meta-analysis. A comprehensive search of PubMed and EMBASE was performed using MeSH terms and keywords including “psoriatic arthritis,” “nail,” and “ultrasonography.” Random-effects models calculated pooled mean differences for nail thickness, and heterogeneity was assessed using the I² statistic.

Results

Among 253 participants (175 PsA, 78 controls), patients with PsA exhibited significantly increased nail plate thickness (mean difference: 0.11 mm, 95% CI: 0.07–0.15, p < 0.001, I² = 12%) and nail bed thickness (mean difference: 0.20 mm, 95% CI: 0.14–0.26, p < 0.001, I² = 18%). Ultrasonographic findings also revealed subclinical enthesitis and increased power Doppler signals indicative of active inflammation. Consistent results across studies highlight ultrasonography's diagnostic reliability.

Conclusion

Ultrasonography is a robust, non-invasive method for evaluating nail involvement in PsA, with increased nail plate and bed thickness serving as reliable markers of disease activity. Standardization of ultrasonographic protocols and further multicenter studies are recommended to validate these findings and expand their clinical application.

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银屑病关节炎中甲受累的超声评价：系统回顾和meta分析

血管受累是银屑病关节炎（PsA）的标志，通常反映疾病的严重程度和全身性炎症。亚临床指甲变化经常先于关节症状，因此早期发现对及时干预至关重要。超声检查，其高频探头和功率多普勒技术，提供了一种非侵入性的方法来评估指甲结构和炎症活动。我们的系统回顾和荟萃分析集中在超声（US）在识别亚临床或早期psa相关的指甲变化中的作用-特别是甲板和甲床厚度。材料和方法按照PRISMA指南进行系统评价和荟萃分析。9项研究纳入定性综合，3项研究纳入定量荟萃分析。使用MeSH术语和关键词，包括“银屑病关节炎”、“指甲”和“超声检查”，对PubMed和EMBASE进行了全面搜索。随机效应模型计算指甲厚度的汇总平均差异，并使用I2统计量评估异质性。结果253名受试者（PsA 175例，对照组78例）中，PsA患者甲板厚度（平均差值0.11 mm, 95% CI: 0.07-0.15, p < 0.001, I2 = 12%）和甲床厚度（平均差值0.20 mm, 95% CI: 0.14-0.26, p < 0.001, I2 = 18%）显著增加。超声检查结果也显示亚临床鼻炎和功率多普勒信号增加，表明活动性炎症。研究结果一致，强调超声诊断的可靠性。结论超声检查是一种可靠的、无创的评估PsA累及指甲的方法，甲板和甲床厚度的增加是疾病活动性的可靠标志。建议超声检查方案的标准化和进一步的多中心研究来验证这些发现并扩大其临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista Colombiana de Reumatologia Medicine-Rheumatology

CiteScore

0.80

自引率

0.00%

发文量

期刊介绍： The Colombian Journal of Rheumatology (Revista Colombiana de Reumatología) is the official organ of the Colombian Association of Rheumatology (Asociación Colombiana de Reumatología) and the Central American, Caribbean and Andean Association of Rheumatology (Asociación Centroamericana Caribe Andina de Reumatología) - ACCA. It was created in December 1993 with the purpose of disseminating scientific information derived from primary and secondary research and presenting cases coming from the practice of Rheumatology in Latin America. Since its foundation, the Journal has been characterized by its plurality with subjects of all rheumatic and osteomuscular pathologies, in the form of original articles, historical articles, economic evaluations, and articles of reflection and education in Medicine. It covers an extensive area of topics ranging from the broad spectrum of the clinical aspects of rheumatology and related areas in autoimmunity (both in pediatric and adult pathologies), to aspects of basic sciences. It is an academic tool for the different members of the academic and scientific community at their different levels of training, from undergraduate to post-doctoral degrees, managing to integrate all actors inter and trans disciplinarily. It is intended for rheumatologists, general internists, specialists in related areas, and general practitioners in the country and abroad. It has become an important space in the work of all rheumatologists from Central and South America.