{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T22:48:33Z","timestamp":1783205313908,"version":"3.54.6"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,2,24]],"date-time":"2014-02-24T00:00:00Z","timestamp":1393200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Arthritis activity assessments in psoriatic arthritis (PsA) have traditionally relied on tender and swollen joint counts, but in rheumatoid arthritis, multiple studies have demonstrated subclinical inflammation using modern imaging. The aim of this study was to compare clinical examination and ultrasound (US) findings in an early PsA cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010nine disease\u2010modifying antirheumatic drug\u2013naive patients with recent\u2010onset PsA (median disease duration 10 months) underwent gray\u2010scale (GS) and power Doppler (PD) US of 40 joints plus tender and swollen joint counts of 68\/66 joints. GS and PD were scored on a 0\u20133 semiquantitative scale for each joint. Clinically active joints were defined as tender and\/or swollen and US active joints were defined as a GS score \u22652 and\/or a PD score \u22651.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The most common sites for subclinical synovitis were the wrist (30.6%), knee (21.4%), metatarsophalangeal (MTP) joints (26.5\u201333.7%), and metacarpophalangeal joints (10.2\u201319.4%). Excluding MTP joints and ankles, 37 (75.5%) of 49 patients had subclinical synovitis with a median of 3 (interquartile range [IQR] 1\u20134) joints involved. In contrast, clinical overestimation of synovitis occurred most commonly at the shoulder (38%) and ankle (28.6%). Twelve of 49 patients were classified clinically as having oligoarthritis; of these, subclinical synovitis identified 8 (75%) as having polyarthritis with an increase in their median joint count from 3 (IQR 1\u20134) to 6 (IQR 5\u20137).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study has demonstrated that subclinical synovitis, as identified by US, is very common in early PsA and led to the majority of oligoarthritis patients being reclassified as having polyarthritis. Further research is required into the relationship of such subclinical synovitis to structural progression.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.22158","type":"journal-article","created":{"date-parts":[[2013,9,11]],"date-time":"2013-09-11T05:14:13Z","timestamp":1378876453000},"page":"432-439","source":"Crossref","is-referenced-by-count":84,"title":["Is There Subclinical Synovitis in Early Psoriatic Arthritis? A Clinical Comparison With Gray\u2010Scale and Power Doppler Ultrasound"],"prefix":"10.1002","volume":"66","author":[{"given":"Jane E.","family":"Freeston","sequence":"first","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C.","family":"Coates","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie L.","family":"Nam","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna R.","family":"Moverley","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine and University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M. A.","family":"Hensor","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Wakefield","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Emery","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip S.","family":"Helliwell","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine and University of Leeds, Leeds, and Bradford Hospitals NHS Trust, St Luke's Hospital Bradford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip G.","family":"Conaghan","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,2,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(01)00872-5"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh199"},{"key":"e_1_2_6_4_1","first-page":"2262","article-title":"Outcome measures in psoriatic arthritis","volume":"32","author":"Gladman DD","year":"2005","journal-title":"J Rheumatol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-008-0835-y"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2327"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22190"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.007062"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110421"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23945"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.149377"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker078"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.075101"},{"key":"e_1_2_6_14_1","first-page":"159","article-title":"Ultrasonography in the early diagnosis of psoriasis\u2010associated enthesopathy","volume":"27","author":"Filippis LG","year":"2005","journal-title":"Int J Tissue React"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2007.08.005"},{"key":"e_1_2_6_16_1","first-page":"S68","article-title":"Detection of inflammation in early psoriatic arthritis by ultrasound: a longitudinal study [abstract]","volume":"63","author":"Nigg AP","year":"2011","journal-title":"Arthritis Rheum"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/30.5.339"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0049-0172(73)90035-8"},{"key":"e_1_2_6_19_1","first-page":"127","article-title":"Psoriatic arthritis (PSA): an analysis of 220 patients","volume":"62","author":"Gladman DD","year":"1987","journal-title":"Q J Med"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/30.4.245"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200350"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker420"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-14-101"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21972"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.089243"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2004.05.003"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.60.7.641"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200004)43:4<865::AID-ANR18>3.0.CO;2-W"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200017"}],"container-title":["Arthritis Care &amp; 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