Ultrasound in the Management of Patients With Psoriatic Arthritis: Systematic Literature Review and Novel Algorithms for Pragmatic Use

Research output: Contribution to journalReviewResearchpeer-review

  • Hélène Gouze
  • Marina Backhaus
  • Peter Balint
  • Andrea Di Matteo
  • Walter Grassi
  • Annamaria Iagnocco
  • Esperanza Naredo
  • Richard J. Wakefield
  • Østergaard, Mikkel
  • Paul Emery
  • Maria Antonietta D’Agostino

Objective. In 2015, the European Alliance of Associations for Rheumatology (EULAR) published recommendations for the use of imaging for the diagnosis and management of spondyloarthritis (SpA) in clinical practice. These recommendations included the use of ultrasound (US) in patients with psoriatic arthritis (PsA), but the management was not clearly distinguished from that of SpA. We aimed to systematically review the literature on the role of US for the management of PsA, and to propose pragmatic algorithms for its use in clinical practice. Methods. A group of 10 rheumatologists, experienced in imaging and musculoskeletal US, met with the objectives of formulating key questions for a systematic literature review (SLR), appraising the available evidence, and then proposing algorithms on the application of US in suspected or established PsA, based on both the literature and experts’ opinions following a Delphi process. Results. The SLR included 120 articles, most of which focused on the diagnostic process. The elevated number of articles retrieved suggests the interest of rheumatologists in using US in the management of PsA. After a consensual discussion on literature data and expert opinion, the following 3 algorithms were developed to be used in practical situations: suspicion of PsA, management of PsA with good clinical response, and management of PsA with insufficient clinical response. Conclusion. The SLR showed interest by rheumatologists in using US to objectively evaluate PsA for diagnosis and management. We propose 3 practical algorithms to guide its use in the clinical management of patients, from diagnosis to the assessment of treatment response. Further studies are needed to define remission and to assess the ability of US to predict disease severity.

Original languageEnglish
JournalJournal of Rheumatology
Volume51
Issue number1
Pages (from-to)50-60
Number of pages11
ISSN0315-162X
DOIs
Publication statusPublished - 2024

Bibliographical note

Publisher Copyright:
© 2024 The Journal of Rheumatology.

    Research areas

  • arthritis, psoriasis, psoriatic arthritis, ultrasonography

ID: 381722073