Comparison of three screening tools to detect psoriatic arthritis in patients with psoriasis (CONTEST study).

Background: Multiple questionnaires to screen for psoriatic arthritis (PsA) have been developed but the optimal screening questionnaire is unknown.

Objectives: To compare three PsA screening questionnaires in a head-to-head study using CASPAR (the Classification Criteria for Psoriatic Arthritis) as the gold standard.

Methods: This study recruited from 10 U.

Debridement of painful forefoot plantar callosities in rheumatoid arthritis: the CARROT randomised controlled trial.

The objective of this study was to evaluate the long-term benefits of sharp scalpel debridement of painful forefoot plantar callosities in rheumatoid arthritis (RA). The null hypothesis: sharp scalpel debridement would offer no additional long-term advantage in terms of pain and function. Sixty-five people with RA were randomised to receive regular sharp scalpel debridement of painful forefoot plantar callosities in conjunction with a combined therapeutic approach or a combined therapeutic approach alone.

GRAPPA Responder Index Project (GRACE): a report from the GRAPPA 2011 annual meeting.

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) established the GRAPPA Composite Exercise (GRACE) to compare existing and emerging composite disease activity and responder measures. At the GRAPPA 2010 annual meeting, initial results from this project were presented, and voting on available measures took place. At the GRAPPA 2011 meeting, further comparisons of new and existing measures were made, along with an outline plan for further work.

Enthesitis in psoriatic disease.

Enthesitis is increasingly recognized as an important component in psoriatic arthritis (PsA). Improved imaging techniques have expanded our understanding of the role of enthesitis in PsA and provided methods for earlier detection and assessment. Increased knowledge about the extent of tendon and ligament involvement has led to the theory that enthesitis may be the primary event in PsA.

The time-dependent accumulation of protoporphyrin IX fluorescence in nodular basal cell carcinoma following application of methyl aminolevulinate with an oxygen pressure injection device.

Topical protoporphyrin (PpIX)-induced photodynamic therapy (PDT) relies on the penetration of the prodrug into the skin lesion and subsequent accumulation of the photosensitizer. Methyl aminolevulinate (MAL)-PDT is an established treatment for thinner and superficial non-melanoma skin cancers (NMSCs) but for the treatment of the thicker nodular basal cell carcinoma (nBCC) enhanced penetration of the prodrug is required. This study employed a new higher pressure, oxygen pressure injection (OPI) device, at the time of Metvix® application with a view to enhancing the penetration of MAL into the tumors.

Magnetic resonance arthrography of lesser metatarsophalangeal joints in patients with rheumatoid arthritis: relationship to clinical, biomechanical, and radiographic variables.

Objective: Our exploratory study of painful lesser metatarsophalangeal (MTP) joints in patients with rheumatoid arthritis (RA) primarily aimed to compare the clinical, biomechanical, and plain radiography findings with magnetic resonance (MR) arthrography findings. Our secondary aim was to compare standard unenhanced MR with MR arthrography in imaging the lesser MTP joints in RA.

Methods: In 15 patients with RA, the more symptomatic forefoot was imaged using 3T MR imaging.

The development of candidate composite disease activity and responder indices for psoriatic arthritis (GRACE project).

Objective: To develop new composite disease activity indices for psoriatic arthritis (PsA).

Methods: Data from routine clinic visits at multiple centres were collected in a systematic manner. Data included all domains identified as important in randomised controlled trials in PsA.

The radiological assessment of axial involvement in psoriatic arthritis.

This article summarizes the state of radiological assessment of axial involvement in psoriatic arthritis (PsA). The definition and measurement of axial disease in PsA remain problematic and this situation in turn could affect the choice of approach to evaluate radiological findings of the spine. At present, the radiological assessment has been evaluated by using scoring systems borrowed from ankylosing spondylitis (AS).

Remission in psoriatic arthritis.

Psoriatic arthritis (PsA) is a multifaceted disease that challenges outcome methodologists. A number of measures have been used to define remission in PsA but they have been mostly articular. Composite measures of disease activity and low disease states are now emerging, but further work is required to assess the implications of achieving these goals and to develop cost-effective treatment strategies to achieve them.

Quantitative MRI measurements of the Achilles tendon in spondyloarthritis using ultrashort echo times.

Objectives: Tendon involvement is common in spondyloarthritis. The MRI signal from the Achilles tendon has been used to quantify mechanical tendinopathy; however, conventional MRI is limited by the short T(2) of normal tendon. Short and ultrashort echo time (UTE) MRI have the potential to better measure signal intensity reflecting changes in T(2) or gadolinium enhancement.

Is there subclinical enthesitis in early psoriatic arthritis? A clinical comparison with power doppler ultrasound.

Objective: Enthesitis is a recognized feature of spondylarthritides (SpA), including psoriatic arthritis (PsA). Previously, ultrasound imaging has highlighted the presence of subclinical enthesitis in established SpA, but there are little data on ultrasound findings in early PsA. The aim of our study was to compare ultrasound and clinical examination (CE) for the detection of entheseal abnormalities in an early PsA cohort.

Sensitivity and specificity of the classification of psoriatic arthritis criteria in early psoriatic arthritis.

Objective: To assess the sensitivity and specificity of the Classification of Psoriatic Arthritis (CASPAR) Study Group criteria in early psoriatic arthritis (PsA) and to compare them with the sensitivity and specificity of the Moll and Wright criteria.

Methods: The CASPAR Study Group criteria were applied to patients with early PsA (<24 months symptom duration) and to control patients with other new-onset inflammatory arthritides. Both groups were naive to all disease-modifying antirheumatic drugs.

Pressure and pain in systemic sclerosis/scleroderma--an evaluation of a simple intervention (PISCES): randomised controlled trial protocol.

Background: Foot problems associated with Systemic Sclerosis (SSc)/Scleroderma have been reported to be both common and disabling. There are only limited data describing specifically, the mechanical changes occurring in the foot in SSc. A pilot project conducted in preparation for this trial confirmed the previous reports of foot related impairment and reduced foot function in people with SSc and demonstrated a link to mechanical etiologies.

Linear pitting and splinter haemorrhages are more commonly seen in the nails of patients with established psoriasis in comparison to psoriatic arthritis.

Background: Recently the role of several ligament and tendon insertions around the nail matrix and nail plate have been identified as possible contributory factors that explain the higher prevalence of nail involvement in psoriatic arthritis (PsA). The purpose of this study was to determine whether such anatomical factors might also be associated with different patterns of nail involvement in skin psoriasis and PsA.

Methods: A total of 173 patients were recruited: 121 PsA cases and 52 psoriasis cases.

Development of composite measures for psoriatic arthritis: a report from the GRAPPA 2010 annual meeting.

Composite disease outcome measures have been used in rheumatology for some time, but a disease-specific composite measure for psoriatic arthritis (PsA) has not yet been validated. Currently, instruments developed for use in rheumatoid arthritis are employed in PsA and include the American College of Rheumatology response criteria (ACR20, 50, and 70) and the Disease Activity Score for 28 and 44 joints (DAS28 and DAS44); however, these instruments do not cover the full spectrum of psoriatic disease. A composite measure is one way of incorporating an assessment of all relevant clinical outcomes into one single measure.

Capturing all of the costs in NICE appraisals: the impact of inflammatory rheumatic diseases on productivity.

Inflammatory rheumatic diseases are common. It is estimated that ∼2.1% of the population has an inflammatory rheumatic disease (Andrianakos A, Trontzas P, Christoyannis F et al.

Evaluation of a solid-supported tagging strategy for mass spectrometric analysis of peptides.

We have explored two divinylbenzene cross-linked polystyrene supports for use in a solid-supported N-terminal peptide tagging strategy. Resin-bound tags designed to be cleaved in a single step at the N-terminus of peptides have been devised and explored as peptide N-terminal tagging reagents (constructs) for subsequent mass spectrometric analysis. While the brominated tagging approach shows promise, the use of these specific solid supports has drawbacks, in terms of tagging reaction scale, for real applications in proteomics.

MRI identifies plantar plate pathology in the forefoot of patients with rheumatoid arthritis.

Previous cadaveric studies have suggested that forefoot deformities at the metatarsophalangeal (MTP) joints in patients with rheumatoid arthritis (RA) might result from the failure of the ligamentous system and displacement of the plantar plates. This study aimed to examine the relationship between plantar plate pathology and the rheumatoid arthritis magnetic resonance imaging score (RAMRIS) of the lesser (second to fifth) MTP joints in patients with RA using high-resolution 3 T magnetic resonance imaging (MRI). In 24 patients with RA, the forefoot was imaged using 3 T MRI.

A case series to describe the clinical characteristics of foot ulceration in patients with rheumatoid arthritis.

The aim of this study was to describe the clinical characteristics of foot ulceration in patients with rheumatoid arthritis (RA). Adults with RA and current foot ulceration but without diabetes were recruited. Clinical examination included assessment of RA disease activity, foot deformity, peripheral vascular disease, neuropathy and plantar pressures.

Application of composite disease activity scores in psoriatic arthritis to the PRESTA data set.

Objective: This study aimed to compare the performances of the Modified Composite Psoriatic Disease Activity Index (mCPDAI) and the Disease Activity index for PSoriatic Arthritis (DAPSA) in an interventional study of etanercept in psoriatic arthritis.

Methods: The components of the CPDAI and DAPSA were extracted using PRESTA (Psoriasis Randomized Etanercept STudy in subjects with psoriatic Arthritis) study data. Data for four of the five domains of the CPDAI-thus an mCPDAI-were available: joints, skin, dactylitis and enthesitis (spinal involvement was not assessed).

European League Against Rheumatism recommendations for the management of psoriatic arthritis with pharmacological therapies.

Background: Psoriatic arthritis (PsA) is a clinically heterogeneous disease. Clear consensual treatment guidance focused on the musculoskeletal manifestations of PsA would be advantageous. The authors present European League Against Rheumatism (EULAR) recommendations for the treatment of PsA with systemic or local (non-topical) symptomatic and disease-modifying antirheumatic drugs (DMARD).

A survey of the images used on the Arthritis Research UK (ARUK) Osteomalacia Mind-Map in relation to cultural background.

Objective: To explore the appropriateness of the images in the Arthritis Research UK Mind-Map for Osteomalacia with people for whom it was intended (Bengali; Gujarati; Hindi; Punjabi and Urdu).

Methods: Participants were identified in a convenient sample from contacts within their communities. They were asked to comment on the images for meaning, suitability and offence to people from their culture.

Development of a disease severity and responder index for psoriatic arthritis (PsA)--report of the OMERACT 10 PsA special interest group.

Work within the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) to develop and validate composite disease activity measures in PsA has progressed. At the Outcome Measures in Rheumatology Clinical Trials (OMERACT) 8 meeting, a core set of domains to be assessed in randomized controlled trials (RCT) and longitudinal observational studies (LOS) of PsA was agreed upon. At OMERACT 10, work to date regarding proposed composite responder indices was presented.

Use of conservative and surgical foot care in an inception cohort of patients with rheumatoid arthritis.

Objectives: To describe conservative and surgical foot care in patients with RA in England and explore factors that predict the type of foot care received.

Methods: Use of podiatry and type of foot surgery were outcomes recorded in an inception cohort involving nine rheumatology centres that recruited patients with RA between 1986 and 1998 across England. Associations between patient-specific factors and service use were identified using univariate logistic regression analyses.