title: The Swedish Early Psoriatic Arthritis Registry 5-year Followup: Substantial Radiographic Progression Mainly in Men with High Disease Activity and Development of Dactylitis.
abstract: OBJECTIVE
  To describe early radiographic findings in patients from the Swedish psoriatic arthritis (SwePsA) registry, progression of destruction, correlations with clinical disease variables, and predictors of destruction.
  
  
  METHODS
  Hand and foot radiographs were available for 72 of 197 SwePsA patients followed for 5 years. Clinical data were collected according to the SwePsA protocol.
  
  
  RESULTS
  Disease characteristics and clinical improvement were similar in men and women. Radiographic abnormalities were more pronounced in men. Total Wassenberg radiographic score at baseline was 0 in 45% of men and 51% of women. One man and one woman had a score > 10. At 5 years, total score was 0 in 14% of men and 40% of women (p = 0.018); 17% of men and 7% of women had scores > 10. Mean total scores for men and women had increased. Baseline erythrocyte sedimentation rate was associated with baseline total radiographic score. In men, swollen joint count was positively, and in women tender joint count negatively, correlated to total radiographic score. After 5 years, only male scores, mainly hand scores, significantly correlated with 28-joint Disease Activity Score and Disease Activity Index for Psoriatic Arthritis scores, swollen joint count, and dactylitis. Achieving remission or minimal disease activity after 5 years protected against structural damage, mainly in men.
  
  
  CONCLUSIONS
  Radiographic progression in early PsA was generally slow but substantial. Male sex appears to be a risk factor for early radiographic damage while the presence of baseline radiographic damage and dactylitis developing during followup seem to predict further destruction. Hand and foot radiograph scoring cannot be substituted with clinical signs.
authors.affiliation: From the Skåne University Hospital, Center for Medical Imaging and Physiology, Lund; Department of Rheumatology, Uppsala University, Uppsala; Falu Lasarett, Rheumatology, Falun; Umeå University, Public Health and Clinical Medicine/Rheumatology, Umeå; Karolinska University Hospital, Rheumatology, Stockholm; Spenshult Hospital, Rheumatology, Olofström; Lund University, Rheumatology, Skåne University Hospital, Malmö, Sweden.M. Geijer, MD, PhD, Skåne University Hospital Lund, Center for Medical Imaging and Physiology; U. Lindqvist, MD, PhD, Department of Rheumatology, Uppsala University; T. Husmark, MD, Falu Lasarett, Rheumatology; G.M. Alenius, MD, PhD, Umeå University, Public Health and Clinical Medicine/Rheumatology; P.T. Larsson, MD, PhD, Karolinska University Hospital, Rheumatology; A. Teleman, MD, Spenshult Hospital, Rheumatology; E. Theander, MD, PhD, Lund University, Rheumatology, Skåne University Hospital, Malmö. mats.geijer@med.lu.se.
authors.forename: Mats
authors.initials: M
authors.lastname: Geijer
authors.affiliation: From the Skåne University Hospital, Center for Medical Imaging and Physiology, Lund; Department of Rheumatology, Uppsala University, Uppsala; Falu Lasarett, Rheumatology, Falun; Umeå University, Public Health and Clinical Medicine/Rheumatology, Umeå; Karolinska University Hospital, Rheumatology, Stockholm; Spenshult Hospital, Rheumatology, Olofström; Lund University, Rheumatology, Skåne University Hospital, Malmö, Sweden.M. Geijer, MD, PhD, Skåne University Hospital Lund, Center for Medical Imaging and Physiology; U. Lindqvist, MD, PhD, Department of Rheumatology, Uppsala University; T. Husmark, MD, Falu Lasarett, Rheumatology; G.M. Alenius, MD, PhD, Umeå University, Public Health and Clinical Medicine/Rheumatology; P.T. Larsson, MD, PhD, Karolinska University Hospital, Rheumatology; A. Teleman, MD, Spenshult Hospital, Rheumatology; E. Theander, MD, PhD, Lund University, Rheumatology, Skåne University Hospital, Malmö.
authors.forename: Ulla
authors.initials: U
authors.lastname: Lindqvist
authors.affiliation: From the Skåne University Hospital, Center for Medical Imaging and Physiology, Lund; Department of Rheumatology, Uppsala University, Uppsala; Falu Lasarett, Rheumatology, Falun; Umeå University, Public Health and Clinical Medicine/Rheumatology, Umeå; Karolinska University Hospital, Rheumatology, Stockholm; Spenshult Hospital, Rheumatology, Olofström; Lund University, Rheumatology, Skåne University Hospital, Malmö, Sweden.M. Geijer, MD, PhD, Skåne University Hospital Lund, Center for Medical Imaging and Physiology; U. Lindqvist, MD, PhD, Department of Rheumatology, Uppsala University; T. Husmark, MD, Falu Lasarett, Rheumatology; G.M. Alenius, MD, PhD, Umeå University, Public Health and Clinical Medicine/Rheumatology; P.T. Larsson, MD, PhD, Karolinska University Hospital, Rheumatology; A. Teleman, MD, Spenshult Hospital, Rheumatology; E. Theander, MD, PhD, Lund University, Rheumatology, Skåne University Hospital, Malmö.
authors.forename: Tomas
authors.initials: T
authors.lastname: Husmark
authors.affiliation: From the Skåne University Hospital, Center for Medical Imaging and Physiology, Lund; Department of Rheumatology, Uppsala University, Uppsala; Falu Lasarett, Rheumatology, Falun; Umeå University, Public Health and Clinical Medicine/Rheumatology, Umeå; Karolinska University Hospital, Rheumatology, Stockholm; Spenshult Hospital, Rheumatology, Olofström; Lund University, Rheumatology, Skåne University Hospital, Malmö, Sweden.M. Geijer, MD, PhD, Skåne University Hospital Lund, Center for Medical Imaging and Physiology; U. Lindqvist, MD, PhD, Department of Rheumatology, Uppsala University; T. Husmark, MD, Falu Lasarett, Rheumatology; G.M. Alenius, MD, PhD, Umeå University, Public Health and Clinical Medicine/Rheumatology; P.T. Larsson, MD, PhD, Karolinska University Hospital, Rheumatology; A. Teleman, MD, Spenshult Hospital, Rheumatology; E. Theander, MD, PhD, Lund University, Rheumatology, Skåne University Hospital, Malmö.
authors.forename: Gerd-Marie
authors.initials: GM
authors.lastname: Alenius
authors.affiliation: From the Skåne University Hospital, Center for Medical Imaging and Physiology, Lund; Department of Rheumatology, Uppsala University, Uppsala; Falu Lasarett, Rheumatology, Falun; Umeå University, Public Health and Clinical Medicine/Rheumatology, Umeå; Karolinska University Hospital, Rheumatology, Stockholm; Spenshult Hospital, Rheumatology, Olofström; Lund University, Rheumatology, Skåne University Hospital, Malmö, Sweden.M. Geijer, MD, PhD, Skåne University Hospital Lund, Center for Medical Imaging and Physiology; U. Lindqvist, MD, PhD, Department of Rheumatology, Uppsala University; T. Husmark, MD, Falu Lasarett, Rheumatology; G.M. Alenius, MD, PhD, Umeå University, Public Health and Clinical Medicine/Rheumatology; P.T. Larsson, MD, PhD, Karolinska University Hospital, Rheumatology; A. Teleman, MD, Spenshult Hospital, Rheumatology; E. Theander, MD, PhD, Lund University, Rheumatology, Skåne University Hospital, Malmö.
authors.forename: Per T
authors.initials: PT
authors.lastname: Larsson
authors.affiliation: From the Skåne University Hospital, Center for Medical Imaging and Physiology, Lund; Department of Rheumatology, Uppsala University, Uppsala; Falu Lasarett, Rheumatology, Falun; Umeå University, Public Health and Clinical Medicine/Rheumatology, Umeå; Karolinska University Hospital, Rheumatology, Stockholm; Spenshult Hospital, Rheumatology, Olofström; Lund University, Rheumatology, Skåne University Hospital, Malmö, Sweden.M. Geijer, MD, PhD, Skåne University Hospital Lund, Center for Medical Imaging and Physiology; U. Lindqvist, MD, PhD, Department of Rheumatology, Uppsala University; T. Husmark, MD, Falu Lasarett, Rheumatology; G.M. Alenius, MD, PhD, Umeå University, Public Health and Clinical Medicine/Rheumatology; P.T. Larsson, MD, PhD, Karolinska University Hospital, Rheumatology; A. Teleman, MD, Spenshult Hospital, Rheumatology; E. Theander, MD, PhD, Lund University, Rheumatology, Skåne University Hospital, Malmö.
authors.forename: Annika
authors.initials: A
authors.lastname: Teleman
authors.affiliation: From the Skåne University Hospital, Center for Medical Imaging and Physiology, Lund; Department of Rheumatology, Uppsala University, Uppsala; Falu Lasarett, Rheumatology, Falun; Umeå University, Public Health and Clinical Medicine/Rheumatology, Umeå; Karolinska University Hospital, Rheumatology, Stockholm; Spenshult Hospital, Rheumatology, Olofström; Lund University, Rheumatology, Skåne University Hospital, Malmö, Sweden.M. Geijer, MD, PhD, Skåne University Hospital Lund, Center for Medical Imaging and Physiology; U. Lindqvist, MD, PhD, Department of Rheumatology, Uppsala University; T. Husmark, MD, Falu Lasarett, Rheumatology; G.M. Alenius, MD, PhD, Umeå University, Public Health and Clinical Medicine/Rheumatology; P.T. Larsson, MD, PhD, Karolinska University Hospital, Rheumatology; A. Teleman, MD, Spenshult Hospital, Rheumatology; E. Theander, MD, PhD, Lund University, Rheumatology, Skåne University Hospital, Malmö.
authors.forename: Elke
authors.initials: E
authors.lastname: Theander
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D015331:Cohort Studies; D016001:Confidence Intervals; D018450:Disease Progression; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D011859:Radiography; D012042:Registries; D012720:Severity of Illness Index; D012737:Sex Factors; D013548:Sweden; D013997:Time Factors; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents
keywords: DESTRUCTION; DISEASE ACTIVITY SCORE; JOINT EROSIONS; OUTCOME; PSORIATIC ARTHRITIS; RADIOGRAPHY