title: Detection of subclinical ultrasound enthesopathy and nail disease in patients at risk of psoriatic arthritis.
abstract: OBJECTIVE
  To detect subclinical entheses and nail abnormalities using gray-scale (GS) and power Doppler ultrasonography (PDUS) between patients with nail psoriasis and those with inverse and scalp psoriasis.
  
  
  METHODS
  In this prospective monocentric study, patients with nail, inverse and scalp psoriasis, without psoriatic arthritis or systemic treatment, were included. Clinical evaluation and ultrasonographic assessment of 14 entheses and 12 nails were done by a dermatologist (clinical assessment) and a rheumatologist (ultrasonographic assessment).
  
  
  RESULTS
  518 entheses were analyzed, with no statistical difference between the two groups when considering GS enthesopathy (P=0.66). PDUS signal of the entheses were low (<1%) in both groups. Matrix thickness was significantly higher in patients with nail disease (1.94mm vs. 1.77mm; P=0.007). PDUS of the skin thickness at the level of distal joint and the loss of the trilaminar appearance were also significantly associated with nail psoriasis (P=0.037 and P<0.0001 respectively).
  
  
  CONCLUSIONS
  Detection of subclinical US enthesopathy is not so rare in both groups, unlike PD signal, but with no statistical difference. US are a good tool to evaluate the different components of psoriatic nails (loss of trilaminar appearance, nail thickening and inflammation of the skin thickness) which are significantly associated with nail psoriasis.
authors.affiliation: Department of Dermatology, Brest University Hospital, 29280 Brest, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Acquitter
authors.affiliation: Department of Dermatology, Brest University Hospital, 29280 Brest, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Misery
authors.affiliation: Department of Rheumatology, Brest University Hospital, 29280 Brest, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Saraux
authors.affiliation: Ultrasound Unit Department, Brest University Hospital, 29280 Brest, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Bressollette
authors.affiliation: Department of Rheumatology, Brest University Hospital, 29280 Brest, France; Ultrasound Unit Department, Brest University Hospital, 29280 Brest, France. Electronic address: sandrine.jousse-joulin@chu-brest.fr.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Jousse-Joulin
mesh_terms: D000328:Adult; D015535:Arthritis, Psoriatic / Q000000981:diagnostic imaging / Q000453:epidemiology*; D058345:Asymptomatic Infections / Q000453:epidemiology*; D015331:Cohort Studies; D000070676:Enthesopathy / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D011565:Psoriasis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D018570:Risk Assessment; D012535:Scalp / Q000000981:diagnostic imaging / Q000503:physiopathology; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler / Q000379:methods*
keywords: Enthesopathy; Nail disease; Psoriasis; Ultrasonography