{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:53:20Z","timestamp":1789480400703,"version":"build-2803163510"},"reference-count":15,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:sec><jats:title>Importance<\/jats:title><jats:p>Psoriasis affects up to 3% of the population, with 30% of patients with psoriasis developing psoriatic arthritis (PsA), yet the transition between psoriasis and PsA has yet to be fully understood. Subclinical synovitis is a hallmark of PsA and is thought to precede psoriatic arthritis; its detection among patients with psoriasis without musculoskeletal (MSK) involvement through medical imaging modalities could offer valuable insights into the transition from psoriasis to PsA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the prevalence of synovitis on ultrasonograms and magnetic resonance imaging (MRI) among patients with psoriasis without MSK involvement compared with healthy controls and patients with PsA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>A comprehensive literature search was conducted in MEDLINE, Embase, Scopus, and Web of Science from inception to October 2024 using keywords related to psoriasis, synovitis, and medical imaging. A PROSPERO protocol was registered (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024571308\">CRD42024571308<\/jats:ext-link>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Selection<\/jats:title><jats:p>Studies were eligible if they included patients with psoriasis without MSK involvement and assessed synovitis using imaging. Two reviewers independently screened studies and extracted data. Discrepancies were resolved by consensus. Twelve of 5132 initially identified studies met inclusion criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Extraction and Synthesis<\/jats:title><jats:p>Data were extracted per PRISMA guidelines. Risk of bias was assessed using the Newcastle-Ottawa Scale. A random-effects model was used to pool risk ratios (RRs) for synovitis prevalence across comparison groups. Heterogeneity was assessed using the <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> statistic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was the presence of imaging-detected synovitis among patients with psoriasis without MSK involvement compared with healthy controls and patients with PsA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve studies (N\u2009=\u20092606 patients) were included comprising 1593 patients with psoriasis (mean [SD] age, 46.4 [7.5] years; 982 men [61.6%]), 327 patients with PsA (mean [SD] age, 50.2 [7.1] years; 210 men [64.2%]), and 686 healthy controls (mean [SD] age, 45.7 [6.9] years; 281 of 576 men [48.8%]). Synovitis was 2.5 times more likely among patients with psoriasis than controls (RR, 2.55; 95% CI, 1.18-5.52). Detection rates were higher with MRI (RR, 6.40; 95% CI, 1.87-21.95) than ultrasonography (RR, 2.50; 95% CI, 1.10-5.67). Synovitis was more frequent among patients with PsA than those with psoriasis, but the difference was not statistically significant (RR, 0.50; 95% CI, 0.13-1.87).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Relevance<\/jats:title><jats:p>This systematic review and meta-analysis found that subclinical synovitis is significantly more prevalent among patients with psoriasis without MSK involvement compared with healthy controls. This finding suggests that imaging may aid in identifying individuals at risk for progression to psoriatic arthritis.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2025.2281","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T15:00:18Z","timestamp":1752678018000},"page":"966","source":"Crossref","is-referenced-by-count":9,"title":["Subclinical Synovitis Among Patients With Psoriasis Without Musculoskeletal Involvement"],"prefix":"10.1001","volume":"161","author":[{"given":"Shanti","family":"Mehta","sequence":"first","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Xiong","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dea","family":"Metko","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parsa","family":"Abdi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Memorial University of Newfoundland, St John\u2019s, Newfoundland, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"McMullen","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raed","family":"Alhusayen","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"12","key":"dbr250005r1","doi-asserted-by":"publisher","first-page":"2068","DOI":"10.1136\/annrheumdis-2015-208821","article-title":"Subclinical joint inflammation in patients with psoriasis without concomitant psoriatic arthritis: a cross-sectional and longitudinal analysis.","volume":"75","author":"Faustini","year":"2016","journal-title":"Ann Rheum Dis"},{"issue":"2","key":"dbr250005r2","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1007\/s10067-017-3895-z","article-title":"Magnetic resonance imaging (MRI) of feet demonstrates subclinical inflammatory joint disease in cutaneous psoriasis patients without clinical arthritis.","volume":"37","author":"Mathew","year":"2018","journal-title":"Clin Rheumatol"},{"issue":"1","key":"dbr250005r3","doi-asserted-by":"publisher","first-page":"242","DOI":"10.3390\/jcm13010242","article-title":"Pediatric psoriasis with or without arthritis: does it make a difference?","volume":"13","author":"Ollech","year":"2023","journal-title":"J Clin Med"},{"key":"dbr250005r4","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keae399","article-title":"Subclinical psoriatic arthritis and disease interception\u2014where are we in 2024?","author":"L\u00f3pez-Medina","year":"2025","journal-title":"Rheumatology"},{"issue":"6","key":"dbr250005r5","doi-asserted-by":"publisher","first-page":"3943","DOI":"10.1007\/s00330-023-09493-4","article-title":"The role of ultrasound in screening subclinical psoriatic arthritis in patients with moderate to severe psoriasis.","volume":"33","author":"Chen","year":"2023","journal-title":"Eur Radiol"},{"issue":"4","key":"dbr250005r6","doi-asserted-by":"publisher","first-page":"495","DOI":"10.31138\/mjr.180923.ues","article-title":"Ultrasonography enthesitis and synovitis screening in psoriatic patients: a case control study.","volume":"34","author":"Boussaid","year":"2023","journal-title":"Mediterr J Rheumatol"},{"issue":"4","key":"dbr250005r7","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/j.ejr.2020.02.007","article-title":"Cutaneous immunohistochemical expression of interleukin-23 receptor (IL-23R) in psoriasis and psoriatic arthritis patients: relation to musculoskeletal ultrasound findings.","volume":"42","author":"El-Leithy","year":"2020","journal-title":"Egypt Rheumatol"},{"issue":"4","key":"dbr250005r8","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.ejr.2020.07.003","article-title":"Nail affection as a central part of the entheseal organ in psoriasis patients for early detection of psoriatic arthritis.","volume":"42","author":"ElMallah","year":"2020","journal-title":"Egypt Rheumatol"},{"issue":"6","key":"dbr250005r9","doi-asserted-by":"publisher","first-page":"1627","DOI":"10.1007\/s10067-019-04445-0","article-title":"Subclinical synovitis and enthesitis in psoriasis patients and controls by ultrasonography in Saudi Arabia; 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