Doppler Ultrasonography on Small Joints of Hands and Feet to Assess Subclinical Affection in Patients with Psoriasis

Abstract

Abstract Background Psoriasis, a systemic inflammatory disease, often manifests as plaque psoriasis, affecting 80-90% of patients. Psoriatic arthritis (PsA) diagnosis relies on CASPAR criteria, with ultrasound, especially power Doppler, proving valuable in assessing severity and treatment response. PsA causes deformity, dysfunction, and significantly impairs patients' quality of life. Aim of the Work To asses subclinical affection of peripheral joints in psoriatic patients without symptoms of arthropathy. Patients and Methods A cross-sectional study conducted at Ain Shams University Hospital involved 70 psoriasis patients recruited from dermatology clinics. The study, adhering to ethical standards, utilized comprehensive methods, including medical history, clinical examinations, routine laboratory tests, and musculoskeletal ultrasound with power Doppler. The cross-sectional design allowed assessment of various aspects of psoriasis and its associated conditions. Results This cross-sectional study of 70 psoriatic patients revealed that musculoskeletal involvement was more prevalent in females (57.7%) and those with a BMI >24 (kg/m2). Higher PASI scores (>5) correlated with increased risk. Treatment with topical steroids and methotrexate showed positive associations. In multivariate analysis, female gender and PASI score >5 remained significant predictors of musculoskeletal affection in psoriatic patients (p < 0.05). Conclusion The study underscores the significance of evaluating musculoskeletal issues in psoriatic patients. Female gender, higher BMI, smoking, and elevated PASI scores were linked to musculoskeletal involvement. Treatment with topical steroids and methotrexate correlated with such issues. Female gender and higher PASI scores were independent predictors of musculoskeletal concerns.