活动性手部炎症。类风湿关节炎和银屑病关节炎患者的不同临床和超声表现——一项横断面、多中心研究。

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine Pub Date : 2025-04-30 DOI:10.1016/j.jbspin.2025.105916

Julio Ramírez , Vicenç Torrente-Segarra , Andrea Cuervo , Mireia Moreno , Ana Belén Azuaga , Lourdes Mateo , Beatriz Frade-Sosa , Andrea Zacarías , Noemí Busquets-Pérez , Susana Holgado , Paula Estrada , Oscar Camacho , Juan José De Agustín , Carme Moragues , María Bonet , Sandra Farietta , Patricia Corzo , Andrés Ponce , Virginia Ruiz-Esquide , Lucía Alascio , Juan D. Cañete

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引用次数: 0

摘要

目的：明确类风湿关节炎（RA）和银屑病关节炎（PsA）患者手部炎症活动性的超声（US）特征。方法：本横断面、多中心研究收集了RA和PsA患者活动性手部炎症的流行病学和临床资料。对腕关节和掌指关节进行超声检查，重点是伸肌腱和屈肌腱。结果：共纳入292例患者，其中女性192例（61.7%），平均年龄56.1岁，平均病程105.4个月。血清阳性91例（31.1%），血清阴性79例（27%），PsA 122例（41.7%）。总体而言，125名患者（42.8%）表现出糜烂性疾病，103名患者（35.2%）接受了靶向治疗。所有患者均为活动性疾病(平均SDAI: 29.5；平均DAPSA: 22.3)。在队列中，144例（49.3%）患者表现为滑膜肥厚（SH） bbbb2 +功率多普勒（PD）。血清阳性（72.5%）比血清阴性（43%）或PsA (36%) （p2+PD）更常见。与血清阳性RA（9.8%）和血清阴性RA（18.9%）相比，PsA中伸肌腱副炎更常见（27%）。(结论：滑膜滑膜炎是RA的特征，而PsA中腱副炎更常见。SH bbbb2 +PD与糜烂性疾病相关，强调需要前瞻性研究来验证US作为关节炎的决策工具。

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Active hand inflammation. Differing clinical and ultrasound patterns in patients with rheumatoid arthritis and psoriatic arthritis – A cross-sectional, multicenter study

Objectives

To define ultrasound (US) characteristics in patients with Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PsA) exhibiting active hand inflammation.

Methods

This cross-sectional, multicenter study collected epidemiological and clinical data from RA and PsA patients with active hand inflammation. US examinations of wrists and metacarpophalangeal joints were performed, focusing on extensor and flexor tendons.

Results

A total of 292 patients were included: 192 (61.7%) were women, with a mean age of 56.1 years and mean disease duration of 105.4 months. Ninety-one patients (31.1%) had seropositive RA, 79 (27%) had seronegative RA, and 122 (41.7%) had PsA. Overall, 125 patients (42.8%) exhibited erosive disease, with 103 (35.2%) receiving targeted therapies. All patients had active disease (mean SDAI: 29.5; mean DAPSA: 22.3). Among the cohort, 144 patients (49.3%) showed synovial hypertrophy (SH) ≥ 2 + Power Doppler (PD). This was more common in seropositive (72.5%) than in seronegative RA (43%) or PsA (36%) (P ≤ 0.001). Erosive disease (OR 8.4 [3.9–18], P ≤ 0.001) and US global score (OR 1.1 [1–1.1], P ≤ 0.001) were associated with SH ≥ 2 + PD. Extensor paratenonitis was more frequent in PsA (27%) compared to seropositive (9.8%) and seronegative RA (18.9%) (P ≤ 0.01). The number of swollen joints (OR 1.1 [1–1.2], P ≤ 0.001) and joint ankylosis (OR 4.3 [1.1–16.9], P ≤ 0.05) were positively associated with paratenonitis.

Conclusions

Synovial pannus was characteristic of RA, while paratenonitis was more common in PsA. SH ≥ 2 + PD correlated with erosive disease, highlighting the need for prospective studies to validate US as a decision-making tool in arthritis.

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来源期刊

Joint Bone Spine 医学-风湿病学

CiteScore

4.50

自引率

11.90%

发文量

184

审稿时长

25 days

期刊介绍： Bimonthly e-only international journal, Joint Bone Spine publishes in English original research articles and all the latest advances that deal with disorders affecting the joints, bones, and spine and, more generally, the entire field of rheumatology. All submitted manuscripts to the journal are subjected to rigorous peer review by international experts: under no circumstances does the journal guarantee publication before the editorial board makes its final decision. (Surgical techniques and work focusing specifically on orthopedic surgery are not within the scope of the journal.)Joint Bone Spine is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.