Key clinical point: In patients with moderate-to-severe psoriasis, the presence of synovio-enthesitis on ultrasound, particularly in lower limbs, indicated progression to subclinical psoriatic arthritis (PsA). Therefore, routine ultrasound screening should be performed irrespective of arthritis symptoms.
Major finding: Only synovio-enthesitis diagnosis differed significantly among patients with silent psoriasis vs control individuals (16.1% vs 1.3%; P < .001), with 12.7% of patients diagnosed with synovio-enthesitis progressing to subclinical PsA and the top four sites with synovio-enthesitis involvement being in lower limbs. Body surface area and Psoriasis Area and Severity Index scores were not different in psoriasis, subclinical PsA, and prodromal/active PsA phases.
Study details: This cross-sectional study included 490 patients with moderate-to-severe psoriasis, of which 384 and 106 patients without and with arthritis symptoms formed the silent psoriasis and clinical PsA groups, respectively, and 80 age- and sex-matched control individuals without psoriasis.
Disclosures: This study was supported by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.
Source: Chen ZT et al. The role of ultrasound in screening subclinical psoriatic arthritis in patients with moderate to severe psoriasis. Eur Radiol . 2023 (Feb 28). Doi: 10.1007/s00330-023-09493-4