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Unmet Need in Psoriatic Arthritis: Discriminate Inflammatory from Degenerative Lesions...
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Unmet Need in Psoriatic Arthritis: Discriminate Inflammatory from Degenerative Lesions Using Imaging

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Immunology".

Deadline for manuscript submissions: closed (20 December 2022) | Viewed by 12682

Special Issue Editor

Dr. Ilaria Tinazzi

E-Mail Website
Guest Editor
Unit of Rheumatology, Sacro Cuore Don Calabria Cancer Care Center, Via don A. Sempreboni, 5, 37024 Negrar, Verona, Italy
Interests: psoriatic arthritis; muscolo-scheletal ultrasound; spondiloartrhritis; entheropatic arthritis

Special Issue Information

Dear Colleagues,

Psoriatic Arthritis (PsA) is a chronic and heterogeneous inflammatory arthropathy. New therapeutic opportunities have changed our treatment strategies in the last decade, and imaging techniques allowing its early detection are more performant, but the discrimination of degenerative manifestations and lesions from inflammatory ones remains challenging.

The definition of axial involvement has changed over the years, from unilateral sacroiliitis to a process similar to anchylosing spondylitis, but we still miss an appropriate tool to identify axial PsA, mostly because it overlaps with degenerative lesions. Moreover, we have few imaging data evaluating drug efficacy in spine diseases, and spinal involvement was often explored with clinical tools.

Distal interphalangeal involvement is similar to erosive osteoarthritis, and, also in this case, data from imaging studies to clarify the differences between the two processes and to assess therapy efficacy are missing.

In this Special Issue, we welcome the submission of original research and review articles presenting and discussing imaging data that may help disease diagnosis and therapeutic decisions by clinicians for patients with clinical manifestations different from classical dactylitis or polyarthritis.

Dr. Ilaria Tinazzi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • PsA
  • Osteoarthritis
  • Axial PsA
  • MRI
  • Ultrasound
  • Distal interphalangeal joints
  • Cervical spine

Published Papers (4 papers)

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Research

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12 pages, 703 KiB  
Article
Degenerative and Inflammatory Osteoproliferations in Lumbar Radiographs in Psoriatic Arthritis Patients
by Gizem Ayan, Abdurrahman Sadic, Levent Kilic and Umut Kalyoncu
J. Clin. Med. 2022, 11(7), 2009; https://doi.org/10.3390/jcm11072009 (registering DOI) - 3 Apr 2022
Viewed by 4399
Abstract
The aim of this study was to determine the distribution different types of osteoproliferative lesions on the lumbar spine and their relations in patients with psoriatic arthritis (PsA) under biologic-disease-modifying anti-rheumatic drug therapy. T12-S1 corners were evaluated in 182/274 (66.4%) patients with lumbar [...] Read more.
The aim of this study was to determine the distribution different types of osteoproliferative lesions on the lumbar spine and their relations in patients with psoriatic arthritis (PsA) under biologic-disease-modifying anti-rheumatic drug therapy. T12-S1 corners were evaluated in 182/274 (66.4%) patients with lumbar radiographs. Lesions were determined as osteophyte (grade 0–3), erosion, sclerosis, squaring, corner syndesmophyte, and bridging syndesmophyte. Lesions with no clear distinction were defined as ambiguous. The mean (SD) age of 182 PsA (69.2% female) patients was 47.6 years (12.7), the mean age at diagnosis of PsA was 39.7 years (12.7). Of the patients, 112 (61.5%) met the criteria for mNY. Osteophytes were the most frequently detected lesions (42.3%), with 18.1% of patients having osteophyte grade 2 and above (mostly on L2-L4). Syndesmophytes were present in 24.2% of all patients (mostly on T12-L4), and ambiguous lesions were detected in 13 (4.7%) patients. Changes were observed in five ambiguous lesions in patients with follow-up lumbar radiography, four of them transformed into corner syndesmophytes at follow-up, and one was evaluated as osteophyte grade 2. Approximately one fifth of patients presented with significant degenerative new bone formation, and syndesmophytes were found in one fourth. In approximately 7% of all patients, lesions were ambiguous. The nature of these lesions needs to be evaluated in further imaging studies. Full article
(This article belongs to the Special Issue Unmet Need in Psoriatic Arthritis: Discriminate Inflammatory from Degenerative Lesions Using Imaging)
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11 pages, 418 KiB  
Article
Use of Ultrasonography to Discriminate Psoriatic Arthritis from Fibromyalgia: A Post-Hoc Analysis of the ULISSE Study
by Antonio Marchesoni, Pierluigi Macchioni, Stefania Gasparini, Carlo Perricone, Fabio Massimo Perrotta, Rosa Daniela Grembiale, Ettore Silvagni, Roberta Ramonda, Luisa Costa, Alen Zabotti, Giacomo Curradi, Giuliana Gualberti, Francesca Marando and Carlo Salvarani
J. Clin. Med. 2022, 11(1), 180; https://doi.org/10.3390/jcm11010180 - 29 Dec 2021
Cited by 5 | Viewed by 1420
Abstract
In psoriatic arthritis (PsA) patients with concomitant chronic widespread pain, the differential diagnosis with fibromyalgia syndrome (FMS) can be challenging. We evaluated whether ultrasound (US) examination of entheseal sites can distinguish pain from (PsA) enthesitis versus FMS. PsA and FMS patients underwent clinical [...] Read more.
In psoriatic arthritis (PsA) patients with concomitant chronic widespread pain, the differential diagnosis with fibromyalgia syndrome (FMS) can be challenging. We evaluated whether ultrasound (US) examination of entheseal sites can distinguish pain from (PsA) enthesitis versus FMS. PsA and FMS patients underwent clinical evaluation and gray-scale (GS; B-mode) and power Doppler (PD) US examination of the entheses. At least one enthesis with GS- and PD-mode changes was found in 90% and 59.3% of PsA patients (n = 140) and 62.7% and 35.3% of FMS patients (n = 51), respectively. GS and PD identified changes in 49.5% and 19.2% of the 840 PsA entheses and 22.5% and 7.9% of the 306 FMS entheses, respectively. Receiver operating characteristic curve analysis showed an area under the curve of 0.77 and 0.66 for B- and PD-mode, respectively, 3.5 being the best cut-off GS-score to discriminate the two conditions. Multivariate regression showed that Achilles and proximal patellar tendon enthesitis (B-mode) were strongly associated with PsA (odds ratio, ~2). Principal component analysis (B-mode) confirmed that PsA patients have a higher number of involved entheses and patterns of entheseal involvement than FMS patients. US evaluation of the entheses may help differentiate chronic widespread pain from PsA versus FMS. Full article
(This article belongs to the Special Issue Unmet Need in Psoriatic Arthritis: Discriminate Inflammatory from Degenerative Lesions Using Imaging)
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Review

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11 pages, 933 KiB  
Review
Axial Psoriatic Disease: Clinical and Imaging Assessment of an Underdiagnosed Condition
by Ivan Giovannini, Alen Zabotti, Carmelo Cicciò, Matteo Salgarello, Lorenzo Cereser, Salvatore De Vita and Ilaria Tinazzi
J. Clin. Med. 2021, 10(13), 2845; https://doi.org/10.3390/jcm10132845 - 27 Jun 2021
Cited by 11 | Viewed by 3347
Abstract
The frequent involvement of the spine and sacroiliac joint has justified the classification of psoriatic arthritis (PsA) in the Spondyloarthritis group. Even if different classification criteria have been developed for PsA and Spondyloarthritis over the years, a well-defined distinction is still difficult. Although [...] Read more.
The frequent involvement of the spine and sacroiliac joint has justified the classification of psoriatic arthritis (PsA) in the Spondyloarthritis group. Even if different classification criteria have been developed for PsA and Spondyloarthritis over the years, a well-defined distinction is still difficult. Although the majority of PsA patients present peripheral involvement, the axial involvement needs to be taken into account when considering disease management. Depending on the definition used, the prevalence of axial disease may vary from 25 to 70% in patients affected by PsA. To date, no consensus definition has been reached in the literature and the definition of axial involvement in PsA has varied from isolated sacroiliitis to criteria used in ankylosing spondylitis. This article reviews the unmet needs in the clinical and radiological assessment of axial PsA, reporting the various interpretations of axial involvement, which have changed over the years. Focusing on both imaging and clinical standpoints, we reported the prevalence of clinical and radiologic features, describing the characteristics of axial disease detectable by X-rays, magnetic resonance imaging, and PET-CT, and also describing the axial symptoms and outcome measures in patients affected by axial disease. Full article
(This article belongs to the Special Issue Unmet Need in Psoriatic Arthritis: Discriminate Inflammatory from Degenerative Lesions Using Imaging)
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13 pages, 979 KiB  
Review
Hand Erosive Osteoarthritis and Distal Interphalangeal Involvement in Psoriatic Arthritis: The Place of Conservative Therapy
by Elena Poletto, Ilaria Tinazzi, Antonio Marchetta, Nicola Smania and Elena Rossato
J. Clin. Med. 2021, 10(12), 2630; https://doi.org/10.3390/jcm10122630 - 15 Jun 2021
Cited by 5 | Viewed by 8089
Abstract
Hand erosive osteoarthritis (HEOA) and Psoriatic Arthritis (PsA) with DIP involvement are common diseases affecting the hand. Both of them evolve with a progressive limitation in grip due to limited range of motion of the affected joints and stenosing tenosynovitis. Pharmacological options currently [...] Read more.
Hand erosive osteoarthritis (HEOA) and Psoriatic Arthritis (PsA) with DIP involvement are common diseases affecting the hand. Both of them evolve with a progressive limitation in grip due to limited range of motion of the affected joints and stenosing tenosynovitis. Pharmacological options currently available (corticosteroids and clodronate or Idrossicloroquine) for the treatment of EHOA are mostly symptomatic and currently there are no effective drugs able to modify the course of the disease. In addition, data on drug effectiveness of PsA with DIP involvement are lacking. Conservative therapy should be considered in order to reduce pain and improve hand functionality. There are many studies debating a wide range of non-pharmacological intervention in the management of HEOA: joint protection program, range of motion and strengthening exercise, hand exercise with electromagnetic therapy, application of heat with paraffin wax or balneotherapy, occupational therapy and education. Concerning conservative treatment strategies to treat PsA, on the contrary, current evidence is still weak. Further research is needed to find the correct place of physical therapy to prevent stiffness and ankylosis due to the vicious circle of inflammation-pain-immobility-rigidity. Full article
(This article belongs to the Special Issue Unmet Need in Psoriatic Arthritis: Discriminate Inflammatory from Degenerative Lesions Using Imaging)
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