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enthesitis in patients with psoriatic arthritis: A nationwide data from the Chinese Registry of Psoriatic Arthritis (CREPAR)

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Chinese Medical Journal 2023年第8期136卷 951-958页

作者： Fan Yang Chaofan Lu Huilan Liu Lei Dou Yanhong Wang Hongbin Li Xinwang Duan Lijun Wu Yongfu Wang Xiuying Zhang Jian Xu Jinmei Su Dong Xu Jiuliang Zhao Qingjun Wu Mengtao Li Xiaomei Leng Xiaofeng Zeng Department of Rheumatology and Clinical Immunology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeNational Clinical Research Center for Dermatologic and Immunologic Diseases(NCRC-DID)Key Laboratory of Rheumatology and Clinical ImmunologyMinistry of EducationBeijing 100730China Department of Rheumatology and Immunology The Second People’s Hospital of WuhuWuhuAnhui 241000China Department of Epidemiology and Biostatistics Institute of Basic Medical SciencesChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100005China The Division of Rheumatology The Affiliated Hospital of Inner Mongolia Medical UniversityHohhotInner Mongolia 010110China Department of Rheumatology The Second Affiliated Hospital of Nanchang UniversityNanchangJiangxi 330006China Department of Rheumatology and Immunology The People’s Hospital of the Xinjiang Uygur Autonomous RegionUrumqiXinjiang 830001China Department of Rheumatology First Affiliated Hospital of Baotou Medical CollegeBaotouInner Mongolia 014010China Department of Rheumatology Zibo Central HospitalZiboShandong 255036China Department of Rheumatology The First Affiliated Hospital of Kunming Medical UniversityKunmingYunnan 650032China

Background:The clinical features of enthesitis in patients with psoriatic arthritis(PsA)have been reported in some Western countries,but data in China are very limited.This study aimed to describe the characteristics of enthesitis in Chinese patients with PsA and compared them with those in other cohorts.Methods:Patients with PsA enrolled in the Chinese Registry of Psoriatic Arthritis(CREPAR)(December 2018 to June 2021)were included.Data including demographics,clinical characteristics,disease activity measures,and treatment were collected at enrollment.enthesitis was assessed by the Spondyloarthritis Research Consortium of Canada(SPARCC),Maastricht ankylosing spondylitis enthesitis score(MASES),and Leeds enthesitis index(LEI)indices.A multivariable logistic model was used to identify factors related to enthesitis.We also compared our results with those of other cohorts.Results:In total,1074 PsA patients were included,308(28.7%)of whom had enthesitis.The average number of enthesitis was 3.3±2.8(range:1.0–18.0).More than half of the patients(165,53.6%)had one or two tender entheseal sites.Patients with enthesitis had an earlier age of onset for both psoriasis and arthritis,reported a higher proportion of PsA duration over 5 years,and had a higher percentage of axial involvement and greater disease activity.Multivariable logistic regression showed that axial involvement(odds ratio[OR]2.21,95%confidence interval[CI],1.59–3.08;Penthesitis.Compared with the results of other studies,Chinese patients with enthesitis had a younger age,lower body mass index(BMI),a higher rate of positive human leukocyte antigen(HLA)-B27,more frequent dactylitis,and a higher proportion of conventional synthetic disease-modifying antirheumatic drugs’(csDMARDs)use.Conclusions:enthesitis is a common condition among Chinese patients with PsA.It is import

关键词： enthesitis Psoriatic arthritis Registry

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Ultrasonographic evaluation of enthesitis in patients with ankylosing spondylitis

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The Journal of Biomedical Research 2017年第2期31卷 162-169页

作者： Huayong Zhang Jun Liang Junlan Qiu Fan Wang Lingyun Sun Department of Rheumatologyand Immunology The Affiliated Drum Tower Hospital of Nanjing University Medical SchoolNanjingJiangsu 210008China Departments of Rheumatology and Immunology The Affiliated Drum Tower Hospital of Nanjing University Medical SchoolNanjingJiangsu 210008China Ultrasound Intervention The Affiliated Drum Tower Hospital of Nanjing University Medical SchoolNanjingJiangsu 210008China

The aim of this study was to assess sensitivity and responsiveness of power Doppler ultrasound （PDUS） in detecting enthesitis for ankylosing spondylitis （AS） patients compared to clinical examinations. Twenty AS patients initiating etanerceptunderwent clinical and PDUS examinations of six bilateral entheseal sites at baseline and after 1, 2 and 3 months of treatment. Clinical and PDUS examinations identified at least one entheseal lesion in nine （45%） and 19 （95%） patients, respectively. Furthermore, of 240 entheseal sites examined in these 20 patients, PDUS detected 123 entheseal lesions （51.3% of sites）, compared with only 47 entheseal lesions （19.6%） detected by clinical examination （P〈0.05）. The entheseal lesions found on PDUS were most commonly identified by calcification （33.3%）, tendon edema （29.2%）, abnormal blood flow （25.8%）, a thickened tendon （22.1%）, cortical irregularity （12.9%）, bony erosions （9.6%） and bursitis at the tendon insertion to the bone cortex （7.1%）. Improvements in clinical symptoms and laboratory parameters, and significant decreases in PDUS scores were observed following treatment with etanereept. Improvements in PDUS scores continued during follow-up in patients who entered remission following treatment. In conclusion, PDUS improves detection of structural and inflammatory abnormalities of the enthesis in AS compared to physical examination. In addition, PDUS may be useful inascertaining medications.

关键词： power Doppler ultrasound enthesitis ankylosing spondylitis

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Power Doppler ultrasonographic assessment of the ankle in patients with inflammatory rheumatic diseases

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World Journal of Orthopedics 2014年第5期5卷 574-584页

作者： Takeshi Suzuki Division of Rheumatology Mitsui Memorial Hospital

Ankle involvement is frequent in patients with inflammatory rheumatic diseases, but accurate evaluation by physical examination is often difficult because of the complex anatomical structures of the ankle. Over the last decade, ultrasound(US) has become a practical imaging tool for the assessment of articular and periarticular pathologies, including joint synovitis, tenosynovitis, and enthesitis in rheumatic diseases. Progress in power Doppler(PD) technology has enabled evaluation of the strength of ongoing inflammation. PDUS is very useful for identifying the location and kind of pathologies in rheumatic ankles as well as for distinguishing between inflammatory processes and degenerative changes or between active inflammation and residual damage. The aim of this paper is to illustrate the US assessment of ankle lesions in patients with inflammatory rheumatic diseases, including rheumatoid arthritis, spondyloarthritis, and systemic lupus erythematosus, focusing on the utility of PDUS.

关键词： Ankle Power Doppler Ultrasound Rheumatoid arthritis Psoriatic arthritis Spondyloarthritis Tenosynovitis enthesitis

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