Analysis of periarticular bone changes in patients with cutaneous psoriasis without associated psoriatic arthritis

Simon D, Faustini F, Englbrecht M, Kleyer A, Kocijan R, Haschka J, Finzel S, Kraus S, Hueber A, Sticherling M, Schett G, Rech J (2016)

Publication Type: Journal article

Publication year: 2016

Journal

Annals of the Rheumatic Diseases BMJ Publishing Group

Book Volume: 75

Pages Range: 660-6

Journal Issue: 4

DOI: 10.1136/annrheumdis-2014-206347

Abstract

To search for structural bone changes in the joints of psoriasis patients without psoriatic arthritis (PsA).55 psoriasis patients without any current or past symptoms of arthritis or enthesitis and 47 healthy controls were examined by high-resolution peripheral quantitative CT scans of the metacarpophalangeal joints. Number, size and exact localisation of erosions and enthesiophytes were recorded by analysing axial scans of the metacarpal heads and phalangeal bases and were confirmed in additional coronal and/or sagittal sections. In addition, we collected demographic and clinical data including subtype, duration and severity of psoriasis.Psoriasis patients showed a larger and significantly increased number of enthesiophytes (total number 306; mean±SD/patient 5.62±3.30) compared with healthy controls (total number 138; mean±SD/patient 3.04±1.81, p<0.001). Enthesiophytes were typically found at the dorsal and palmar sides of the metacarpal heads where functional entheses related to extensor and flexor tendons are localised. Bone erosions were rare and not significantly different between psoriasis patients and healthy controls. If present, erosions were almost exclusively found at the radial side of the second metacarpal head in both psoriasis patients and healthy controls.Psoriasis patients without PsA show substantial signs of enthesiophyte formation compared with healthy controls. These changes represent new bone formation at mechanically exposed sites of the joint and substantiate the concept of the existence of a 'Deep Koebner Phenomenon' at enthesial sites in psoriasis patients.

Authors with CRIS profile

Dominic Simon Medizinische Fakultät Matthias Englbrecht Lehrstuhl für Innere Medizin III Arnd Kleyer Department of Medicine 3 – Rheumatology and Immunology Stephanie Finzel Lehrstuhl für Innere Medizin III Sebastian Kraus Lehrstuhl für Innere Medizin III Axel Hueber Department of Medicine 3 – Rheumatology and Immunology Michael Sticherling Professur für Dermatologie Georg Schett Lehrstuhl für Innere Medizin III

Involved external institutions

St. Vincentius-Kliniken / ViDia Kliniken DE Germany (DE)

How to cite

APA:

Simon, D., Faustini, F., Englbrecht, M., Kleyer, A., Kocijan, R., Haschka, J.,... Rech, J. (2016). Analysis of periarticular bone changes in patients with cutaneous psoriasis without associated psoriatic arthritis. Annals of the Rheumatic Diseases, 75(4), 660-6. https://doi.org/10.1136/annrheumdis-2014-206347

MLA:

Simon, Dominic, et al. "Analysis of periarticular bone changes in patients with cutaneous psoriasis without associated psoriatic arthritis." Annals of the Rheumatic Diseases 75.4 (2016): 660-6.

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