Literature on Psoriatic Arthritis

Related ArticlesDeveloping classification criteria for peripheral joint psoriatic arthritis. Step I. Establishing whether the rheumatologist’s opinion on the diagnosis can be used as the “gold standard”.

J Rheumatol. 2006 Mar;33(3):552-7

Authors: Symmons DP, Lunt M, Watkins G, Helliwell P, Jones S, McHugh N, Veale D

OBJECTIVE: The study of psoriatic arthritis (PsA) is hampered by the absence of a widely accepted, validated case definition. We investigated whether the physician’s opinion can be used as a gold standard when developing classification criteria for peripheral joint PsA. METHODS: UK rheumatologists who had published on PsA and attendees at 3 international meetings on PsA held in the UK were polled by questionnaire. There were 3 phases. The first questionnaire asked whether rheumatologists believed in the construct of PsA. The second survey developed a list of features thought to distinguish patients with PsA from other forms of peripheral arthritis. The final phase was development of a series of 61 “paper” patients with various combinations of the features of PsA. The paper patients were assessed by 15 rheumatologists who were asked whether, in their opinion, the patient had PsA. Latent class analysis was used to identify subgroups of patients and cross-tabulations were used to identify which clinical and laboratory features were associated with each subgroup. RESULTS: Rheumatologists agreed on the construct of PsA and that not all patients with psoriasis and an inflammatory polyarthritis have PsA. Latent class analysis identified 3 classes, corresponding to definite PsA; a middle group that was very likely to be given a diagnosis of PsA by some rheumatologists (high diagnosers), but unlikely to be given the diagnosis by others (low diagnosers); and a third group corresponding to “probably not PsA.” CONCLUSION: For the group of patients with “definite PsA” the physician’s opinion can be taken as the gold standard when developing classification criteria. However, for patients in the “middle group” there will always be disagreement with the gold standard whether the standard is based on the opinion of the high diagnosers or the low diagnosers.

PMID: 16463433 [PubMed - in process]

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Related ArticlesMagnetic resonance imaging guided corticosteroid injection of sacroiliac joints in patients with spondylarthropathy. Are multiple injections more beneficial?

Rheumatol Int. 2006 Mar;26(5):396-400

Authors: Günaydin I, Pereira PL, Fritz J, König C, Kötter I

Efficacy of a second magnetic resonance (MR) imaging guided corticosteroid injection of inflamed sacroiliac joints (SIJ) in patients with spondylarthropathy. Thirty-one patients received 50 injections in an outpatient basis. Fifteen of 31 patients who relapsed or were non-responders received a second injection. All had MR guided injection of 40 mg triamcinolone acetonide into SIJ using an open 0.2 Tesla unit. Twenty of 31 patients after the first injection, and 9 of 15 patients after the second injection reported subjective improvement, which lasted for a mean of 8.7+/-10.9 and 16.1+/-15.8 months for each group. Subchondral bone marrow edema resolved in 15 of 20 patients who reported subjective improvement, after the first injection. No complications occurred. MR guided steroid injection of SIJ is effective and safe. Since there is no exposure to radiation it could be performed many times. Repeated injections seem to be beneficial for primary non-responders and patients who relapsed.

PMID: 16010559 [PubMed - as supplied by publisher]

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