Title:A Seven-Joint Ultrasound Score for Differentiating Between Rheumatoid
and Psoriatic Arthritis
Volume: 18
Issue: 4
Author(s): Tanya Sapundzhieva*, Lyubomir Sapundzhiev, Rositsa Karalilova and Anastas Batalov
Affiliation:
- Medical University of Plovdiv, Medical Faculty, Department of Internal Diseases; Plovdiv, Bulgaria
- Rheumatology Department, University Hospital ‘Pulmed’, Plovdiv, Bulgaria
Keywords:
Musculoskeletal ultrasound, rheumatoid arthritis, psoriatic arthritis, synovitis, tenosynovitis, lesions.
Abstract:
Background: Differentiating between seronegative rheumatoid arthritis (RA) and psoriatic
arthritis (PsA) presenting only with the involvement of the small joints of the hands can be
challenging. Implementing musculoskeletal ultrasound (US) to reveal specific patterns of joint and
tendon involvement may have an added value in the management of early arthritis.
Objective: The aim was to investigate whether a seven-joint US score was able to distinguish between
patients with RA and PsA.
Materials and Methods: One hundred and forty-one patients with RA, 65 patients with PsA, and 45
healthy controls (HC) were included in the current study. US assessment of the wrist, second and
third metacarpophalangeal, second and third proximal interphalangeal joint, second and fifth metatarsophalangeal
joint was performed, and the following scores were calculated: synovitis and tenosynovitis/
paratenonitis scores on grayscale ultrasound (GSUS) and on power Doppler (PD) US, erosion
score, US7 score.
Results: RA patients had significantly higher median scores of GS synovitis, PD synovitis, erosions,
and US7 than PsA patients (p < 0.001). PsA patients had significantly higher median scores
of GS tenosynovitis/paratenonitis and PD tenosynovitis/paratenonitis (p < 0.001). All US scores
were significantly higher for both patient groups as compared to the HC group (p < 0.001).
Conclusion: Sonographic evaluation by a seven-joint score can be helpful in the differentiation between
rheumatoid and psoriatic arthritis.
