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Erosion Identification in Metacarpophalangeal Joints in Rheumatoid Arthritis using High-Resolution Peripheral Quantitative Computed Tomography
Published on: October 6, 2023
Diffuse idiopathic skeletal hyperostosis in psoriatic arthritis
Amir Haddad1, Arane Thavaneswaran, Sergio Toloza
1Centre for Prognosis Studies in the Rheumatic Diseases University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada.
The Journal of Rheumatology
|June 18, 2013
Summary
Diffuse idiopathic skeletal hyperostosis (DISH) affects 8.3% of psoriatic arthritis patients. Older age, higher BMI, and peripheral joint damage are associated with DISH in this population.
Area of Science:
- Rheumatology
- Orthopedics
- Radiology
Background:
- Psoriatic arthritis (PsA) is a chronic inflammatory disease.
- Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory spinal condition.
- The co-occurrence and associated factors of DISH in PsA patients are not well-established.
Purpose of the Study:
- To determine the prevalence of DISH in patients with psoriatic arthritis (PsA).
- To identify clinical and radiographic features associated with DISH in PsA patients.
Main Methods:
- Retrospective analysis of the University of Toronto PsA observational cohort (n=938).
- DISH defined by flowing bony bridges in ≥4 contiguous thoracic vertebrae on spinal radiographs.
- PsA patients with DISH were matched by sex to 3 PsA patients without DISH.
- Statistical comparisons included McNemar test, Fisher's exact test, chi-square, paired t test, and logistic regression.
Main Results:
- DISH prevalence was 8.3% (78/938) among PsA patients.
- Patients with DISH were older, had longer disease duration, higher BMI, and higher uric acid levels.
- Higher prevalence of diabetes and hypertension, and greater peripheral joint damage were observed in PsA patients with DISH.
- Older age, higher BMI, and peripheral joint damage were independently associated with DISH in multivariate analysis.
Conclusions:
- DISH can be diagnosed in patients with axial psoriatic arthritis.
- DISH in PsA is associated with established DISH risk factors (older age, high BMI) and peripheral joint damage.
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