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Aplicação de score radiográfico periférico numa população de doentes com artrite psoriática e dactilite
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A artrite psoriática (AP) é uma espondilartrite com envolvimento articular periférico e/ou axial associada a manifestações cutâneas e/ou ungueais. As alterações articulares encontradas nesta doença, a nível periférico, são características – diminuição do espaço articular, erosões, destruição óssea, ossificação nas margens articulares, anquilose e afilamento da falange proximal (em forma de ‘lápis’) e da falange distal em forma de ‘taça, conhecido como ‘pencil-in-cup’. Existem atualmente scores que permitem a avaliação e a caracterização do dano articular com particular importância em ensaios clínicos. Objetivo: Caracterizar e avaliar o dano articular presente nas articulações das mãos e pés dos doentes com AP. Metodologia: Foram avaliadas 46 radiografias das mãos e pés de 23 doentes incluídos no estudo GO-DACT, no Centro Hospitalar Lisboa Norte, e caracterizadas segundo o score Sharp van Der Heijde modificado para a AP (SVDHSAP). Resultados: Todos os doentes incluídos no GO-DACT tinham atingimento articular. 19 doentes apresentaramm envolvimento radiográfico nas mãos e 14 nos pés, sendo que 10 tinham envolvimento simultâneo das mãos e dos pés. Dos 19 com envolvimento articular das mãos, 12 tinham dactilite e dos 14 com envolvimento dos pés, todos tinham evidência de dactilite. O valor médio do SVDHSAP total nesta população foi de 18,4. Nas mãos o valor médio do score de erosões foi de 4,3; da diminuição do espaço articular (DEA) de 4,04;. Nos pés para as erosões nos pés o valor médio foi de 2,65; para a DEA nos pés o valor médio foi de 2,82. Conclusão: Em doentes com artrite psoriática e dactilite o score SVDHSAP foi mais elevado nas articulações das mãos comparativamente aos pés.
Psoriatic arthritis (AP) is a spondylarthritis with peripheral and / or axial joint involvement associated with cutaneous and / or nail manifestations. The articular alterations found in this disease, at the peripheral level, are characteristic - decreased joint space, erosions, bone destruction, ossification in the joint margins, ankylosis and sharpening of the proximal phalanx (in the form of 'pencils') and the distal phalanx in the form of 'cup, known as' pencil-in-cup'. There are currently scores that allow assessment and characterization of joint damage with particular importance in clinical trials. Objective: To characterize and evaluate the joint damage present in the joints of the hands and feet of patients with PA. Methods: A total of 46 radiographs of the hands and feet of 23 patients included in the GO-DACT study at the Centro Hospitalar Lisboa Norte were evaluated, and the patients were classified according to the AP Sharp van Der Heijde score (SVDHSAP). Results: All patients included in the GO-DACT had joint attainment. 19 patients had radiographic involvement in the hands and 14 in the feet, and 10 had simultaneous involvement of the hands and feet. Of the 19 patients with joint involvement of the hands, 12 had dactylitis and 14 with involvement of the feet, all had evidence of dactylitis. The mean SVDHSAP total value in this population was 18.4. In the hands the mean value of the erosion score was 4.3; of the joint space decrease (AED) of 4.04; In the feet for foot erosions the mean value was 2.65; for the AED in the feet the mean value was 2.82. Conclusion: In patients with psoriatic arthritis and dactylitis the SVDHSAP score was higher in the joints of the hands compared to the feet.
Psoriatic arthritis (AP) is a spondylarthritis with peripheral and / or axial joint involvement associated with cutaneous and / or nail manifestations. The articular alterations found in this disease, at the peripheral level, are characteristic - decreased joint space, erosions, bone destruction, ossification in the joint margins, ankylosis and sharpening of the proximal phalanx (in the form of 'pencils') and the distal phalanx in the form of 'cup, known as' pencil-in-cup'. There are currently scores that allow assessment and characterization of joint damage with particular importance in clinical trials. Objective: To characterize and evaluate the joint damage present in the joints of the hands and feet of patients with PA. Methods: A total of 46 radiographs of the hands and feet of 23 patients included in the GO-DACT study at the Centro Hospitalar Lisboa Norte were evaluated, and the patients were classified according to the AP Sharp van Der Heijde score (SVDHSAP). Results: All patients included in the GO-DACT had joint attainment. 19 patients had radiographic involvement in the hands and 14 in the feet, and 10 had simultaneous involvement of the hands and feet. Of the 19 patients with joint involvement of the hands, 12 had dactylitis and 14 with involvement of the feet, all had evidence of dactylitis. The mean SVDHSAP total value in this population was 18.4. In the hands the mean value of the erosion score was 4.3; of the joint space decrease (AED) of 4.04; In the feet for foot erosions the mean value was 2.65; for the AED in the feet the mean value was 2.82. Conclusion: In patients with psoriatic arthritis and dactylitis the SVDHSAP score was higher in the joints of the hands compared to the feet.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019
Palavras-chave
Artrite psoriática Dano articular Erosões Diminuição do espaço articular ScoreSharp van Der Heijde modificado para a Artrite Psoriática Reumatologia