Value of Entheseal Ultrasonography and Serum Cartilage Oligomeric Matrix Protein in the Preclinical Diagnosis of Psoriatic Arthritis

• Published in: Clinical medicine insights. Arthritis and musculoskeletal disorders 2010-01, Vol.2010 (3), p.7-14
• Main Authors: Farouk, Hanan Mohamed, Mostafa, Afaf Abdel Alim, Youssef, Sahar S., Elbeblawy, Moataz Mohammed Samy, Assaf, Naglaa Youssef, Elokda, El Sayed E.
• Format: Article
• Language: English
• Subjects: Diagnosis; Enzyme-linked immunosorbent assay; Original Research; Psoriatic arthritis
• ISSN: 1179-5441; 1179-5441
• DOI: 10.4137/CMAMD.S4461

Hanan Mohamed Farouk1, Afaf Abdel Alim Mostafa2, Sahar S. Youssef3, Moataz Mohammed Samy Elbeblawy4, Naglaa Youssef Assaf5 and El Sayed E. Elokda61Internal Medicine and Rheumatology, 2Clinical Pathology, 3Dermatology and Venereology, 4Radiodiagnosis, 5Rheumatology and Rehabilitation, 6Community Environmental and Occupational Medicine Departments, Faculty of Medicine Ain Shams University, Cairo, Egypt. Abstract Objective: To evaluate the utility of entheseal ultrasonography and serum COMP in the preclinical diagnosis of psoriatic arthritis.Methods: 60 psoriatic patients were divided into: 30 patients with psoriasis (group I) and 30 patients with psoriatic arthritis as control (group II). They underwent independent clinical and ultrasonographic examination of both lower limbs at the calcaneal insertions of Achilles tendons. Psoriatic arthritis disease activity and severity was assessed by modified DAS28 and Steinbrockers scores. Serum levels of COMP were measured for all patients by ELISA.Results: On clinical examination, no entheseal abnormalities were detected in group I while they were present in 23.3% of group II with statistically significant difference between them (P < 0.001). Ultrasonographic entheseal abnormalities were detected in 33.3% of group I and in 46.7% of group II with no significant difference between them (P > 0.05). Serum COMP were significantly elevated in group I and II with no statistically significant difference between them (mean ± SD 5.9 ± 3 and 6.8 ± 12 respectively, P > 0.05). Entheseal ultrasound was more specific (67%) while serum COMP was more sensitive (87%) in the preclinical diagnosis of psoriatic arthritis. Serum COMP levels were significantly correlated with CRP in both groups and with DAS28 and Steinbrockers scores in group II (P < 0.01).Conclusion: Entheseal ultrasonography and serum COMP levels may be used complementary to each other for preclinical diagnosis of psoriatic arthritis. Serum COMP seems to be promising prognostic marker for psoriatic arthritis patients.