title: Ultrasonographic wrist and hand abnormalities in early psoriatic arthritis patients: correlation with clinical, dermatological, serological and genetic indices.
abstract: OBJECTIVE
  The aims of our study are to describe the wrist and hand ultrasound (US) abnormalities compared to clinical examination in early psoriatic arthritis (ePsA) and to analyse their correlation with clinical, dermatological, serological and genetic indices.
  
  
  METHODS
  We analysed 1120 fingers and 224 wrists of 112 early PsA, with MyLab70 Xview (Esaote, linear probe) ultrasound (US). Power Doppler active synovitis (AS), erosions, finger tendons tenosynovitis or peritendinitis (TP) and pseudotenosynovitis (PT), were compared to clinical (BASDAI, SHAQ), dermatological (PASI and psoriasis aspects), serological (ESR, CRP, ACPA) and genetic (HLA haplotypes) indices.
  
  
  RESULTS
  All US abnormalities were present: AS was more frequent at wrists (50/224 [22.3%]), followed by hand PT (68/1120 [6,1%]) and TS (29/1120 [2.6%]), while erosions were rare (10/1120 [0.8%]). US abnormalities were independent of ePsA clinical indices (except erosions - even if represented only in a low percentage - that correlated to BASDAI [p<0.05]), while they were associated to several dermatological (except PASI), serological and genetic parameters: psoriasis (all p<0.0001), palmoplantar psoriasis (wrist and hand AS p<0.0005 and p<0.005, respectively), hand psoriasis (all p<0.0001), nail dystrophy (hand AS p<0.05, PT p<0.0001, erosions p<0.0001); positive CRP (all p<0.0001), ESR (wrist and hand AS p<0.005 and <0.0005, respectively, TS, PT and erosions p<0.0001) and ACPA - even if represented only in 1.78% of patients - (wrist and hand AS and TS p<0.0001, PT p<0.5); HLA-B27 (wrist and hand AS p<0.0001, TS p<0.01, PT p<0.05), -B35 (wrist and hand AS p<0.01 and p<0.05, respectively), -B38 (wrist and hand AS p<0.0001, TS p<0.0001, PT p<0.005), -CW6 (wrist AS p<0.05), -DR4 (wrist and hand AS p<0.0001, TS p<0.0001, PT p<0.005).
  
  
  CONCLUSIONS
  US abnormalities of hand and wrist were independent of clinical ePsA indices (except erosions), while they correlated to dermatological (except PASI), serological and genetic parameters of disease.
authors: Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors: Francesca
authors: F
authors: Bandinelli
authors: Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors: Valentina
authors: V
authors: Denaro
authors: Department of Dermatology, University of Florence, Florence, Italy.
authors: Francesca
authors: F
authors: Prignano
authors: Department of Internal Medicine, University of Tirana, Albania.
authors: Ledio
authors: L
authors: Collaku
authors: Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria Sant'Anna, Ferrara, Italy.
authors: Giovanni
authors: G
authors: Ciancio
authors: Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors: Marco
authors: M
authors: Matucci-Cerinic
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000097:blood / Q000000981:diagnostic imaging* / Q000235:genetics / Q000276:immunology / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D042241:Early Diagnosis; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging*; D020022:Genetic Predisposition to Disease; D006680:HLA Antigens / Q000235:genetics*; D006239:Haplotypes; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012698:Serologic Tests; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*; D018608:Ultrasonography, Doppler; D014955:Wrist Joint / Q000000981:diagnostic imaging*
chemical_list: D015415:Biomarkers; D006680:HLA Antigens