Distal extremity swelling with pitting edema in psoriatic arthritis: A case-control study

F. Cantini, C. Salvarani, I. Olivieri, L. Macchioni, L. Niccoli, A. Padula, C. Falcone, L. Boiardi, A. Bozza, L. Barozzi, P. Pavlica

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Abstract

Objective. To evaluate the frequency and the clinical characteristics of distal extremity swelling with pitting edema in patients with psoriatic arthritis (PsA). Methods. This was a case-control study of consecutive outpatients with PsA (old and new diagnosis) observed over a 3-month period in three secondary referral centers in Italy. As controls we used the two consecutive rheumatic out-patients, excluding those with spondylarthropathies, observed after a PsA patient. The demographic and clinical features were assessed by clinical examination and review of the medical records. Results. A total of 183 patients with PsA and 366 controls were evaluated. Distal extremity swelling with pitting edema was recorded in 39/183 (21%) PsA patients and in 18/366 (4.9%) controls (p <0.0001). In 8/39 (20%) patients this feature presented as a first, isolated manifestation of PsA, and in 8 others it was associated with other features of PsA at diagnosis. The upper and lower extremities were affected, predominantly asymmetrically, in 40% and 60% of the cases respectively. In patients with pitting edema compared to those without this feature, the frequency of Achilles enthesitis and plantar fasciitis, calculated together, was higher (p <0.05) and the duration of arthritis was significantly lower (p = 0.02). In 7 patients the clinical evidence of a predominant involvement of tenosynovial structures was confirmed by MRI. Conclusion. Upper or lower distal extremity swelling with pitting edema due to tenosynovitis, usually unilateral, is a common feature in PsA patients and may represent the first, isolated manifestation of the disease.

Original languageEnglish
Pages (from-to)291-296
Number of pages6
JournalClinical and Experimental Rheumatology
Volume19
Issue number3
Publication statusPublished - 2001

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Keywords

  • Distal swelling with pitting edema
  • Psoriatic arthritis
  • Tenosynovitis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Cite this

Cantini, F., Salvarani, C., Olivieri, I., Macchioni, L., Niccoli, L., Padula, A., Falcone, C., Boiardi, L., Bozza, A., Barozzi, L., & Pavlica, P. (2001). Distal extremity swelling with pitting edema in psoriatic arthritis: A case-control study. Clinical and Experimental Rheumatology, 19(3), 291-296.