Evaluation of early joint damage via ultrasound imaging in patients with psoriasis: a single center retrospective study

Abstract Background: Psoriatic joint damage is occult and often asymptomatic, however, it can cause irreversible permanent joint damage in the late stage and affect the quality of life of patients. It is important to identify potential joint damage early and slow the progression of the disease. Objective: This study aimed to explore the risk factors for early joint damage in patients with psoriasis vulgaris using color Doppler ultrasonography. Methods： Hand joint Doppler ultrasound data of 100 patients with skin psoriasis in the outpatient department of Dermatology of Beijing Chaoyang Hospital from July 2017 to December 2021 were reviewed. We also reviewed the clinical characteristics between the two groups of patients, using statistical methods to analyze the differences in the risk factors between patients with and without symptomatic joint damage and those without joint damage under the early ultrasonic detection of psoriasis. Results： In this study, 100 patients with psoriasis vulgaris were examined using grayscale Doppler ultrasonography. 65 cases (65%) were male, and 39 (39.0%) had joint damage. Two out of 39 patients had psoriatic arthritis in the following 3 years. After multivariate logistic regression analysis, it was found that the independent risk factors for joint damage in patients with psoriasis vulgaris were age (OR: 1.659, 95% CI: 1.217-2.261, P = 0.001), total cholesterol or 1.625, 95% CI: 1.053-2.292, P = 0.006), age at first onset (OR: 1.329, 95% CI: 1.049-1.683, P = 0.019), course of disease ( 1.615, 95% CI: 1.113-1.799, P = 0.005), nail accumulation (OR: 4.137, 95% CI: 1.755-9.752, P = 0.001), smoking (OR: 10.337, 95% CI: 4.109-26.009, P = 0.000), and diabetes (OR:8.575, 95%CI:1.868-39.362, P=0.006). Conclusion: Patients with psoriasis vulgaris and a history of nail damage, smoking, drinking, coronary heart disease, and hyperlipidemia were more likely to have early joint damage. Patients with psoriasis vulgaris with age, elevated total cholesterol, early onset age, nail accumulation, smoking history, and diabetes history should be removed early using joint Doppler ultrasound to exclude early joint damage.