Ultrasound and power Doppler evaluation of the hand and wrist in patients with psoriatic arthritis.
OBJECTIVE
To evaluate the ability of high-resolution and power Doppler sonography in detecting joint and tendon abnormalities in patients with psoriatic arthritis (PsA) of the hands and wrists compared with clinical and radiological findings.


METHODS
Thirty-six patients with psoriatic arthritis of the hands and wrists and 10 healthy controls were examined with ultrasound (US). The degree of synovial proliferation, tenosynovitis, presence of joint effusion as well as the vascularity of synovial tissue was estimated. US findings were scored using a newly devised scoring system.


RESULTS
Thirty-two patients had articular synovial proliferation and/or tenosynovitis/ tendinitis or joint effusion in one or more joints according to US. Twenty-two patients had tendon changes; only five had joint effusion. The synovial, Doppler, and total articular-teno scores were all significantly correlated to the number of swollen joints. The scores, however, did not correlate to other clinical or laboratory measurements of disease activity.


CONCLUSIONS
US proved effective in demonstrating PsA involvement of the hands and wrists and was more sensitive than clinical examination in detecting pathology. Long-term follow-up studies are needed to evaluate whether this can change the traditional approach for assessing involvement of joints and tendons in PsA.
Milosavljevic
J
J
Department of Oncology, Radiology and Clinical Immunology, Uppsala University Hospital, Uppsala, Sweden. jugo.milos@deltamed.se
Lindqvist
U
U
Elvin
A
A
D015535:Arthritis, Psoriatic / Q000175:diagnosis*; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging; D006225:Hand / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012016:Reference Values; D012680:Sensitivity and Specificity; D013710:Tendons / Q000000981:diagnostic imaging; D013717:Tenosynovitis / Q000175:diagnosis; D018608:Ultrasonography, Doppler / Q000379:methods*; D014955:Wrist Joint / Q000000981:diagnostic imaging*