{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T22:59:42Z","timestamp":1776898782015,"version":"3.51.2"},"reference-count":34,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T00:00:00Z","timestamp":1610928000000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005205","name":"Janssen Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005205","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011110","name":"UCB","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011110","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2020,12,12]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Cross-sectional study with 24 participating countries. Patients with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or PsA according to their rheumatologist were included. The investigators were asked which diagnosis out of a list of six (axSpA, PsA, pSpA, inflammatory bowel disease-associated SpA, reactive arthritis or juvenile SpA (Juv-SpA)) fitted the patient best. Peripheral manifestations (ie, peripheral joint disease, enthesitis, dactylitis and root joint disease), their localisation and treatments were evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 4465 patients were included (61% men, mean age 44.5 years) from four geographic areas: Latin America (n=538), Europe plus North America (n=1677), Asia (n=975) and the Middle East plus North Africa (n=1275). Of those, 78% had ever suffered from at least one peripheral musculoskeletal manifestation; 57% had peripheral joint disease, 44% had enthesitis and 15% had dactylitis. Latin American had far more often peripheral joint disease (80%) than patients from other areas. Patients with PsA had predominantly upper limb and small joint involvement (52%).<\/jats:p>\n                  <jats:p>Hip and shoulder involvement was found in 34% of patients. The prevalence of enthesitis ranged between 41% in patients with axSpA and 65% in patients with Juv-SpA. Dactylitis was most frequent among patients with PsA (37%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>These results suggest that all peripheral features can be found in all subtypes of SpA, and that differences are quantitative rather than qualitative. In a high proportion of patients, axial and peripheral manifestations coincided. These findings reconfirm SpA clinical subtypes are descendants of the same underlying disease, called SpA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2020-001450","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T11:35:17Z","timestamp":1610969717000},"page":"e001450","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":110,"title":["Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2309-5837","authenticated-orcid":false,"given":"Clementina","family":"L\u00f3pez-Medina","sequence":"first","affiliation":[{"name":"Rheumatology Department, Cochin Hospital, Assistance Publique H\u00f4pitaux de Paris, Paris, France"},{"name":"ECAMO, INSERM (U1153): Clinical Epidemiology and Biostatistics, University of Paris, Paris, France"},{"name":"Rheumatology Department, Reina Sofia University Hospital, IMIBIC, University of C\u00f3rdoba, C\u00f3rdoba, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2246-1986","authenticated-orcid":false,"given":"Anna","family":"Molto","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Cochin Hospital, Assistance Publique H\u00f4pitaux de Paris, Paris, France"},{"name":"ECAMO, INSERM (U1153): Clinical Epidemiology and Biostatistics, University of Paris, Paris, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0285-9890","authenticated-orcid":false,"given":"Joachim","family":"Sieper","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectious Diseases and Rheumatology, Charit\u00e9 University, Berlin, Germany"}]},{"given":"Tuncay","family":"Duru\u00f6z","sequence":"additional","affiliation":[{"name":"PMR Department, Rheumatology Division, Marmara University 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Buenos Aires University School of Medicine, Buenos Aires, Argentina"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4479-7678","authenticated-orcid":false,"given":"Nelly","family":"Ziade","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Saint-Joseph University and Mount Lebanon Hospital, Beirut, Lebanon"}]},{"given":"Meghna","family":"Gavali","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India"}]},{"given":"Victoria","family":"Navarro-Compan","sequence":"additional","affiliation":[{"name":"Rheumatology Department, University Hospital La Paz, IdiPaz, Madrid, Spain"}]},{"given":"Shue-Fen","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital-Linkou, Taoyuan, 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