Dactylitis in enteropathic spondyloarthritis

Clin Exp Rheumatol. 2016 Sep-Oct;34(5):842-847. Epub 2016 Apr 15.

Abstract

Objectives: Dactylitis has long been recognised as one of the significant features of spondyloarthropathies. In the literature, the prevalence of dactylitis in enteropathic spondyloarthritis (EASpA) ranges between 2% and 4%. The aim of this study was to identify the prevalence of dactylitis in EASpA patients and to investigate its association with clinical subset and with articular and bowel disease activity.

Methods: 78 EASpA patients and 78 controls were enrolled for this study. All patients and controls underwent a rheumatological and a gastroenterological clinical examination. Demographic and clinical features were recorded. Diagnosis of dactylitis was made by physical examination and was evaluated using the Leeds Dactylitis Instrument (LDI).

Results: In our study the prevalence of dactylitis in EASpA was 15.38%, mainly in patients with Crohn's disease (CD) and peripheral arthritis. A significantly higher articular and bowel disease activity was found in patients with dactylitis compared to those without it. The family history of psoriasis represented a predictor of occurrence of dactylitis. Finally, a significant correlation between disease activity and LDI score was found in EASpA.

Conclusions: The results of our study showed a high prevalence of dactylitis in EASpA. It was more frequent in patients with CD and peripheral involvement with a higher articular disease activity, confirming that dactylitis may be a severity marker and a prognostic factor for EASpA. The significant correlation between disease activity and LDI score could address LDI as a potential tool of assessment of dactylitis.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / epidemiology*
  • Crohn Disease / diagnosis
  • Crohn Disease / epidemiology*
  • Female
  • Finger Joint / pathology*
  • Health Status
  • Health Status Indicators
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Pain Measurement
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Severity of Illness Index
  • Spondylarthritis / diagnosis
  • Spondylarthritis / epidemiology*
  • Spondylarthritis / pathology
  • Toe Joint / pathology*
  • Young Adult