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Association between Leeds Dactylitis Index and ultrasonographic features: a multicentre study on psoriatic hand dactylitis

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13

 

  1. Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, and Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Italy.
  2. Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Italy.
  3. Unit of Rheumatology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
  4. Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy.
  5. Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy.
  6. Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy.
  7. Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy.
  8. Unit of Rheumatology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
  9. Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Italy.
  10. Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, and Rheumatology Unit, University of Modena and Reggio Emilia, Italy.
  11. NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds Teaching Hospitals Trust and the University of Leeds, UK.
  12. Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy. rscarpa@unina.it
  13. Rheumatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy.

CER12818
2020 Vol.38, N°6
PI 1112, PF 1117
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PMID: 32242802 [PubMed]

Received: 28/09/2019
Accepted : 17/01/2020
In Press: 03/04/2020
Published: 03/12/2020

Abstract

OBJECTIVES:
The aim of this study was to explore the link between specific sonographic findings and Leeds Dactylitis Index basic (LDI-b) score in psoriatic arthritis (PsA) patients with hand dactylitis.
METHODS:
Ninety-one hand dactylitis were evaluated in a multicentre study for the presence of pain, functional limitation and tenderness (2-point scale) and LDI-b score. Dactylitic fingers were investigated using high-frequency US in grey scale (GS) and power Doppler (PD). According to median LDI-b score value of 12, fingers were then divided into two groups and categorised into quartiles on the basis of the value of ratio of circumference.
RESULTS:
Dactylitic fingers with a LDI-b score >12 showed a significantly higher prevalence of GS flexor tenosynovitis (p=0.015), PD flexor tenosynovitis (p=0.001) and soft tissue oedema (p=0.004), when compared with those with those with LDI-b score <12. GS synovitis at proximal interphalangeal (PIP) level (p=0.003) showed more frequent in dactylitic fingers with a LDI-b score <12, than those with a higher LDI-b value. Fingers in the fourth quartile showed a significantly higher prevalence of GS flexor tenosynovitis of grade ≥2 (p=0.046) and joint synovitis of grade ≥2 at PIP level (p=0.028).
CONCLUSIONS:
We found that high values of LDI are associated with US flexor tenosynovitis and soft tissue oedema in PsA dactylitis. Results suggest a potential role of PIP joint synovitis in the genesis of hand digital swelling and of extra-articular structures alterations in determining the LDI score.

Rheumatology Article