Can Subclinical Inflammation Predict Risk of Psoriatic Arthritis?
Between 15% and 30% of patients with psoriasis develop psoriatic arthritis (PsA). In the majority of cases (60%), the skin disease comes before arthritis. The fact that psoriatic skin disease has a higher prevalence than arthritis raises the question whether patients with psoriasis without PsA are indeed spared from joint inflammation or whether mild changes, which escape physical examination, can be found in some patients. In a recent cross-sectional, longitudinal study conducted in Germany, researchers examined subclinical inflammatory joint disease in patients with psoriasis without psoriatic arthritis (PsA) to determine the changes that may be associated with the later development of PsA. Detecting subclinical joint inflammation could allow better understanding of the transition from skin to joint disease and therefore help to identify patients, who would benefit from more early treatment of the disease.
Results showed that a third of patients with cutaneous psoriasis exhibit subclinical inflammatory changes in the hand. Subclinical inflammation appears to substantially influence the risk of patients with psoriasis to progress to PsA. Both symptoms related to arthralgia as well as subclinical synovitis influence the risk for progression to PsA. More than half of the patients with concomitant presence of arthralgia as well as positive MRI changes develop PsA, but only 15% of patients without such changes did. These findings suggest that subclinical musculoskeletal disease affects a substantial proportion of patients with psoriasis. Together with arthralgia these changes predict the risk for the onset of PsA.
Byline: Martha L. Sikes, MS, RPh, PA-C
Posted: April 18, 2016
Source: Annals of the Rheumatic Diseases
Adapted from the original article.
[Image: Pixabay / Witizia]