The ultrasound imaging module: a report from the GRAPPA 2010 annual meeting

In a plenary session at the 2010 meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), the use of sonography for evaluating articular disease and enthesitis in psoriasis and psoriatic arthritis (PsA) was reviewed. Ultrasound can readily demonstrate signs of synovitis, erosions, and osteoproliferation. There is a need to develop ultrasound joint indices to evaluate and follow PsA longitudinally. Sonography is able to depict ultrastructural features of enthesitis, as well as increased vascularity. Sonographic signs of subclinical enthesitis in patients with psoriasis have been reported by 2 groups, 1 of which has reported limited longitudinal data that suggest baseline composite enthesitis scores may predict future risk of PsA. Although recent studies have studied mostly lower extremity entheses, further work is needed to clarify if other areas need to be included, especially within the framework of the synovial entheseal complex. The study design of the PREPARE (Prevalence of Psoriatic Arthritis in Adults with Psoriasis) trial was also presented.