title: The association of clinical parameters and ultrasound verified inflammation with patients' and physicians' global assessments in psoriatic arthritis.
abstract: To study the association of clinical and/or ultrasound variables with patients' (PGA) and physicians' (EGA) global assessment of disease activity in psoriatic arthritis (PsA). The correlation of these parameters with the discordance between PGA and EGA, as well as with PGA/EGA changes over 6 months was also investigated.
  
  
  
  Prospective study of 83 consecutive PsA patients with 2 visits scheduled 6 months apart. All patients underwent the following assessments: tender (TJC) and swollen joint count (SJC), PASI, dactylitis and Leeds enthesitis index. PGA, patients' level of pain (pain VAS), EGA, and HAQ were also recorded. Grey scale (GS) and power Doppler (PD) ultrasound were performed at 68 joints (evaluating synovia and tendons) and 14 entheses. Regression analyses were performed to assess the association of these variables with PGA and EGA. Two new variables "PGAminusEGA" and "PGAchange - EGAchange" were developed to explore the discrepancy between PGA and EGA and the consistency of PGA/EGA changes over time, respectively.
  
  
  
  The parameters explaining most of PGA and EGA variability were pain VAS (30.5%) and SJC (48.5%), respectively. The correlation between EGA and joint counts was stronger in patients with high vs. low levels of ultrasound verified inflammation. PGAminusEGA was mainly explained by pain and SJC. Pain was the most important predictor of PGA change whereas TJC and HAQ were more closely associated with EGA changes. "PGAchange-EGAchange" was linked to pain and SJC. Ultrasound scores were not linked with either of these variables.
  
  
  
  Pain VAS and joint counts are the most important clinical parameters explaining patients' and physicians' perception of disease activity, whereas the correlation of active inflammation as verified by sonography with these factors is limited.
authors.affiliation: Department of Rheumatology and Immunology of the Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
authors.forename: Angelika
authors.initials: A
authors.lastname: Lackner
authors.affiliation: Department of Internal Medicine VI, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Christina
authors.initials: C
authors.lastname: Duftner
authors.affiliation: Department of Rheumatology and Immunology of the Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
authors.forename: Anja
authors.initials: A
authors.lastname: Ficjan
authors.affiliation: Department of Rheumatology and Immunology of the Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
authors.forename: Judith
authors.initials: J
authors.lastname: Gretler
authors.affiliation: Department of Rheumatology and Immunology of the Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
authors.forename: Josef
authors.initials: J
authors.lastname: Hermann
authors.affiliation: Department of Rheumatology and Immunology of the Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
authors.forename: Rusmir
authors.initials: R
authors.lastname: Husic
authors.affiliation: Department of Rheumatology and Immunology of the Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
authors.forename: Winfried B
authors.initials: WB
authors.lastname: Graninger
authors.affiliation: Department of Rheumatology and Immunology of the Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria. Electronic address: christian.dejaco@gmx.net.
authors.forename: Christian
authors.initials: C
authors.lastname: Dejaco
mesh_terms: D000328:Adult; D015535:Arthritis, Psoriatic / Q000000981:diagnostic imaging*; D005260:Female; D033023:Foot Joints / Q000000981:diagnostic imaging*; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D063189:Symptom Assessment; D014463:Ultrasonography
keywords: Disease activity; Global assessment; Psoriatic arthritis; Ultrasound