Application of ultrasound in the diagnosis of psoriatic arthritis and its comorbidities

doi:10.3760/cma.j.cn441417-20240729-07017

Abstract

Abstract:

Psoriatic arthritis (PsA) is a chronic inflammatory joint disease, as a subtype of psoriasis, often presents as involvement of joints, tendons, enthesitis, nails, and skin. It is also associated with multisystem diseases such as cardiovascular diseases, diabetes, hypertension, and metabolic syndrome. Ultrasound is a safe, sensitive, and convenient imaging method that has been widely used for disease monitoring, treatment efficacy evaluating, and complication diagnosing of PsA. This article reviews the application of ultrasound in the diagnosis and management of PsA and its comorbidities.

Key words:

Psoriatic arthritis, Ultrasound, Musculoskeletal , system , diseases, Finger nail, Non-alcoholic fatty liver disease, Atherosclerotic plaques

摘要：

银屑病关节炎是一种慢性炎症性关节病，属于银屑病的亚型之一，通常表现为关节、肌腱、附着点、指（趾）甲及皮肤受累，并可同时合并心血管疾病、糖尿病、高血压、代谢综合征等多系统疾病。超声为一种安全、敏感、便捷的影像学方法，其应用已覆盖银屑病关节炎的病情监测、疗效评估及并发症诊断等方面。本文就近年来超声在银屑病关节炎及其共病中的应用价值进行综述。

关键词:

银屑病关节炎, 超声, 肌骨系统疾病, 指（趾）甲, 非酒精性脂肪性肝病, 动脉粥样硬化斑块

Wang Xiaonan, Jiao Yuting, Fang Yaqi, Duan Huantong, Yang Zhi.

Application of ultrasound in the diagnosis of psoriatic arthritis and its comorbidities [J]. International Medicine and Health Guidance News, 2025, 31(7): 1130-1134.

王笑楠焦玉婷房娅琪段欢桐杨智.

超声在银屑病关节炎及其共病诊断中的应用价值 [J]. 国际医药卫生导报, 2025, 31(7): 1130-1134.

References

[1] Maeda S, Hayami Y, Naniwa T, et al. The Th17/IL-23 axis and natural immunity in psoriatic arthritis[J]. Int J Rheumatol, 2012,2012: 539683. DOI:10.1155/2012/539683.
[2] 张学军, 郑捷. 皮肤性病学[M]. 9版. 北京: 人民卫生出版社, 2018: 27.
[3] 中华医学会,中华医学会杂志社,中华医学会皮肤性病学分会,等. 银屑病基层诊疗指南(2022年)[J]. 中华全科医师杂志,2022,21(8):705-714. DOI:10.3760/cma.j.cn114798- 20220214-00098.
[4] Mandl P, Navarro-Compán V, Terslev L, et al. EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice[J]. Ann Rheum Dis, 2015,74(7): 1327-1339. DOI:10.1136/annrheumdis-2014-206971.
[5] Freeston JE, Coates LC, Nam JL, et al. Is there subclinical synovitis in early psoriatic arthritis? a clinical comparison with gray-scale and power doppler ultrasound[J]. Arthritis Care Res (Hoboken), 2014,66(3): 432-439. DOI:10.1002/acr.22158.
[6] Mondal S, Goswami RP, Sinha D, et al. Evaluation of subclinical hand joint synovitis by ultrasonography in patients with psoriatic arthritis and cutaneous psoriasis: a case-control study[J]. Mediterr J Rheumatol, 2022,33(4): 421-429. DOI:10.31138/mjr.33.4.421.
[7] Arbault A, Devilliers H, Laroche D, et al. Reliability, validity and feasibility of nail ultrasonography in psoriatic arthritis[J]. Joint Bone Spine, 2016,83(5): 539-544. DOI:10.1016/j.jbspin.2015.11.004.
[8] Bandinelli F, Prignano F, Bonciani D, et al. Ultrasound detects occult entheseal involvement in early psoriatic arthritis independently of clinical features and psoriasis severity[J]. Clin Exp Rheumatol, 2013,31(2): 219-224.
[9] Yamada Y, Inui K, Okano T, et al. Ultrasound assessment, unlike clinical assessment, reflects enthesitis in patients with psoriatic arthritis[J]. Clin Exp Rheumatol, 2021,39(1): 139-145. DOI:10.55563/clinexprheumatol/u8qc6c.
[10] Kane D, Greaney T, Bresnihan B, et al. Ultrasonography in the diagnosis and management of psoriatic dactylitis[J]. J Rheumatol, 1999,26(8): 1746-1751.
[11] Olivieri I, Barozzi L, Favaro L, et al. Dactylitis in patients with seronegative spondylarthropathy. assessment by ultrasonography and magnetic resonance imaging[J]. Arthritis Rheum, 1996,39(9): 1524-1528. DOI:10.1002/art.1780390912.
[12] Wortsman X, Gutierrez M, Saavedra T, et al. The role of ultrasound in rheumatic skin and nail lesions: a multi-specialist approach[J]. Clin Rheumatol, 2011,30(6): 739-748. DOI:10.1007/s10067-010-1623-z.
[13] Essayed SMA, Al-Shatouri MA, Allah YSN, et al. Ultrasonographic characterization of the nails in patients with psoriasis and onychomycosis[J]. Egypt J Radiol Nucl Med, 2015,52(3): 733-739. DOI:10.1016/j.ejrnm.2015.04.009.
[14] Krajewska-Wlodarczyk M, Zuber Z, Owczarczyk-Saczonek A. Ultrasound evaluation of the effectiveness of the use of acitretin in the treatment of nail psoriasis[J]. J Clin Med, 2021,10(10). DOI:10.3390/jcm10102122.
[15] Micali G, Lacarrubba F, Santagati C, et al. Clinical, ultrasound, and videodermatoscopy monitoring of psoriatic patients following biological treatment[J]. Skin Res Technol, 2016,22(3): 341-348. DOI:10.1111/srt.12271.
[16] Dattola A, Altobelli S, Marsico S, et al. Hypodermal adipose tissue sonoelastography for monitoring treatment response in patients with plaque psoriasis[J]. Photomed Laser Surg, 2017,35(9): 484-491. DOI:10.1089/pho.2016.4261.
[17] 耿慧英, 钱林学, 胡向东, 等. 剪切波弹性成像在评估银屑病不同分期中的价值[J]. 中国医学装备, 2016,13(12): 29-32. DOI:10.3969/J.ISSN.1672-8270.2016.12.009.
[18] Guazzaroni M, Ferrari D, Lamacchia F, et al. Shear wave elastography and microvascular ultrasound in response evaluation to calcipotriol+betamethasone foam in plaque psoriasis[J]. Postgrad Med J, 2021,97(1143): 16-22. DOI:10.1136/postgradmedj-2020-138150.
[19] Bellinato F, Gisondi P, Mantovani A, et al. Risk of non-alcoholic fatty liver disease in patients with chronic plaque psoriasis: an updated systematic review and meta-analysis of observational studies[J]. J Endocrinol Invest, 2022,45(7): 1277-1288. DOI:10.1007/s40618- 022-01755-0.
[20] 梁萍,姜玉新. 超声E成像临床应用指南[M]. 北京: 人民卫生出版社, 2018: 95-98.
[21] Ozturk A, Grajo JR, Dhyani M, et al. Principles of ultrasound elastography[J]. Abdom Radiol (NY), 2018, 43(4): 773-785. DOI:10.1007/s00261-018-1475-6.
[22] Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases[J]. Hepatology, 2018,67(1): 328-357. DOI:10.1002/hep.29367.
[23] Eddowes PJ, Sasso M, Allison M, et al. Accuracy of FibroScan controlled attenuation parameter and liver stiffness measurement in assessing steatosis and fibrosis in patients with nonalcoholic fatty liver disease[J]. Gastroenterology, 2019,156(6): 1717-1730. DOI:10.1053/j.gastro.2019.01.042.
[24] Imajo K, Kessoku T, Honda Y, et al. Magnetic resonance imaging more accurately classifies steatosis and fibrosis in patients with nonalcoholic fatty liver disease than transient elastography[J]. Gastroenterology, 2016,150(3): 626-637. DOI:10.1053/j.gastro.2015.11.048.
[25] Petta S, Wong VW, Camma C, et al. Improved noninvasive prediction of liver fibrosis by liver stiffness measurement in patients with nonalcoholic fatty liver disease accounting for controlled attenuation parameter values[J]. Hepatology, 2017,65(4): 1145-1155. DOI:10.1002/hep.28843.
[26] Shen F, Zheng RD, Mi YQ, et al. Controlled attenuation parameter for non-invasive assessment of hepatic steatosis in Chinese patients[J]. World J Gastroenterol, 2014,20(16): 4702-4711. DOI:10.3748/wjg.v20.i16.4702.
[27] 吴惠敏,华静. 受控衰减参数在评估肝脏脂肪变性中的应用[J]. 国际消化病杂志,2018,38(6):353-356. DOI:10.3969/j.issn.1673-534X.2018.06.001.
[28] Kuroda H, Oguri T, Kamiyama N, et al. Multivariable quantitative US parameters for assessing hepatic steatosis[J]. Radiology, 2023,309(1): e230341. DOI:10.1148/radiol.230341.
[29] Tada T, Iijima H, Kobayashi N, et al. Usefulness of attenuation imaging with an ultrasound scanner for the evaluation of hepatic steatosis[J]. Ultrasound Med Biol, 2019,45(10): 2679-2687. DOI:10.1016/j.ultrasmedbio. 2019.05.033.
[30] Tamaki N, Koizumi Y, Hirooka M, et al. Novel quantitative assessment system of liver steatosis using a newly developed attenuation measurement method[J]. Hepatol Res, 2018,48(10): 821-828. DOI:10.1111/hepr.13179.
[31] Cerit M, Şendur HN, Cindil E, et al. Quantification of liver fat content with ultrasonographic attenuation measurement function: correlation with unenhanced multidimensional computerized tomography[J]. Clin Imaging, 2020,65: 85-93. DOI:10.1016/j.clinimag.2020. 04.028.
[32] Tada T, Kumada T, Toyoda H, et al. Utility of attenuation coefficient measurement using an ultrasound-guided attenuation parameter for evaluation of hepatic steatosis: comparison with MRI-determined proton density fat fraction[J]. AJR Am J Roentgenol, 2019,212(2): 332-341. DOI:10.2214/AJR.18.20123.
[33] Fujiwara Y, Kuroda H, Abe T, et al. The B-mode image-guided ultrasound attenuation parameter accurately detects hepatic steatosis in chronic liver disease[J]. Ultrasound Med Biol, 2018,44(11): 2223-2232. DOI:10.1016/j.ultrasmedbio.2018.06.017.
[34] Bende F, Sporea I, Sirli R, et al. Ultrasound-Guided Attenuation Parameter (UGAP) for the quantification of liver steatosis using the Controlled Attenuation Parameter (CAP) as the reference method[J]. Med Ultrason, 2021,23(1): 7-14. DOI:10.11152/mu-2688.
[35] 中华医学会皮肤性病学分会银屑病专业委员会. 中国银屑病诊疗指南(2023版)[J]. 中华皮肤科杂志, 2023,56(7): 573-625. DOI:10.35541/cjd.20220839.
[36] 孙飞一,潘晓芳,贾晓东,等. 多模态超声检查结合临床预测颈动脉粥样硬化患者缺血性脑卒中或短暂性脑缺血复发[J]. 中国医学影像技术,2022,38(1):53-58. DOI:10.13929/j.issn.1003-3289.2022.01.013.
[37] Yan L, Ruan Q, Ye X, et al. The value of multimodal ultrasonic scoring system in the diagnosis of carotid vulnerable plaque: a comparative study with pathology[J]. J Ultrasound Med, 2023,42(9): 2135-2142. DOI:10.1002/jum.16238.
[38] Schinkel AFL, Bosch JG, Staub D, et al. Contrast-enhanced ultrasound to assess carotid intraplaque neovascularization[J]. Ultrasound Med Biol, 2020,46(3): 466-478. DOI:10.1016/j.ultrasmedbio.2019.10.020.
[39] Schmidt C, Fischer T, Ruckert RI, et al. Identification of neovascularization by contrast-enhanced ultrasound to detect unstable carotid stenosis[J]. PLoS One, 2017,12(4): e0175331. DOI:10.1371/journal.pone.0175331.
[40] 李景植,华扬,刘然,等. 超声造影检测颈动脉斑块内新生血管与症状性缺血性脑血管病的相关性研究[J]. 中国脑血管病杂志,2023,20(2):90-95. DOI:10.3969/j.issn.1672-5921. 2023.02.003.
[41] Zhou Y, Wang C. Superb microvascular imaging for detecting neovascularization of carotid plaque compared with contrast-enhanced ultrasound: a protocol for systematic review and meta analysis[J]. Medicine (Baltimore), 2020,99(35): e21907. DOI:10.1097/MD.0000000000021907.
[42] Kuk M, Wannarong T, Beletsky V, et al. Volume of carotid artery ulceration as a predictor of cardiovascular events[J]. Stroke, 2014,45(5): 1437-1441. DOI:10.1161/STROKEAHA.114.005163.
[43] Noflatscher M, Schreinlechner M, Sommer P, et al. Influence of traditional cardiovascular risk factors on carotid and femoral atherosclerotic plaque volume as measured by three-dimensional ultrasound[J]. J Clin Med, 2018,8(1):32. DOI:10.3390/jcm8010032.