In a recent study, researchers found that ultrasound bursitis at entheses could predict the development of inflammatory symptoms linked to psoriatic arthritis (PsA) in patients with mild psoriasis and no initial musculoskeletal signs. The study, conducted at multiple centers, followed 78 patients with mild psoriasis over a median duration of 76.6 months. Ultrasound evaluations were performed on joints and entheses, assessing for synovial hypertrophy, power Doppler signal, and bursitis.
Among the patients who completed the study, a small percentage developed PsA, with over half experiencing musculoskeletal symptoms during the follow-up period. Those who developed musculoskeletal symptoms exhibited higher BMI and abdominal circumference at baseline. Additionally, they reported higher levels of pain and fatigue compared to those who did not develop musculoskeletal symptoms.
The study highlighted that ultrasound bursitis at entheses was prevalent among patients who later developed inflammatory arthralgia suggestive of PsA. Patients who developed musculoskeletal symptoms also showed a significantly higher total joint ultrasound score at baseline, indicating a potential link between ultrasound findings and symptom progression.
The authors emphasized the significance of these findings, noting that patients with psoriasis who developed musculoskeletal symptoms during the study had a higher BMI, more joint ultrasound findings, and reported higher pain and fatigue levels. Conversely, the presence of ultrasound bursitis at entheses was associated with the onset of musculoskeletal symptoms indicative of PsA.
However, the study had limitations, including a relatively small sample size that may have affected the estimation of PsA incidence in psoriasis patients. Furthermore, the exclusion of individuals with musculoskeletal symptoms and those on systemic therapy could have impacted the representation of patients at higher risk for developing PsA.
Supported by research grants from Pfizer and Novartis, the study shed light on the potential predictive value of ultrasound bursitis and higher BMI in identifying musculoskeletal symptoms in patients with mild psoriasis. The authors stressed the importance of early detection and monitoring of these symptoms to potentially prevent the progression to PsA.
This research contributes valuable insights into the association between ultrasound findings, BMI, and the development of musculoskeletal symptoms in psoriasis patients. It underscores the need for further investigation and clinical vigilance to better understand and manage the progression of psoriatic arthritis in this patient population.
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