Objective To evaluate tender joints (TJ) and swollen joints (SJ) for the assessment of ultrasound (US) defined inflammation in PsA. Methods Eighty-three PsA patients underwent clinical and US examinations at two scheduled study visits 12 months apart. Tenderness and swelling were assessed at 68 and 66 joints, respectively, and US examinations were conducted at all 68 joints. At patient level, associations with clinical composites and US scores were performed using correlations and by analysing patients with predominantly tender (pTender) or swollen joints (pSwollen). At joint level, a Power Doppler (PD) value ≥ 1 was defined as active synovitis. A generalized linear mixed model was created to assess the predictive value of TJ and SJ for active synovitis after 12 months. Results SJC showed better correlations with GS/PD scores (r = 0.37/0.47) than with TJC (PD: r = 0.33), while TJC correlated better with patient reported outcomes (PROMs) like patient global assessment (TJC: r = 0.57; SJC r = 0.39). Patients with pTender showed poorer results for PROMs and disease activity scores than patients with pSwollen, but not for laboratory or US markers of inflammation. Swollen joints showed active synovitis in 35% of cases, while only 16% of tender joints were active according to US. Swelling at baseline better predicted active synovitis at the same joint after 12 months [odds ratio (OR) 6.33, P <0.001] as compared with tenderness (OR 3.58, P <0.001). Conclusions SJ are more closely linked with US signs of inflammation as compared with TJ in PsA. Joint swelling is a better predictor for signs of US inflammation than tenderness after one year of follow-up.

中文翻译：

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关节压痛和肿胀在超声评估 PsA 炎症中的作用

目的评估压痛关节 (TJ) 和肿胀关节 (SJ) 以评估超声 (US) 定义的 PsA 炎症。方法 83 名 PsA 患者在相隔 12 个月的两次预定研究访问中接受了临床和超声检查。分别评估了 68 个和 66 个关节的压痛和肿胀，并对所有 68 个关节进行了超声检查。在患者层面，使用相关性并通过分析以压痛 (pTender) 或肿胀关节 (pSwollen) 为主的患者，进行与临床复合材料和 US 评分的关联。在关节水平，功率多普勒 (PD) 值 ≥ 1 被定义为活动性滑膜炎。建立广义线性混合模型以评估 12 个月后 TJ 和 SJ 对活动性滑膜炎的预测价值。结果 SJC 与 GS/PD 评分有更好的相关性（r = 0.37/0。47) 比 TJC (PD: r = 0.33)，而 TJC 与患者报告结果 (PROM) 的相关性更好，如患者整体评估 (TJC: r = 0.57; SJC r = 0.39)。pTender 患者的 PROM 和疾病活动评分的结果比 pSwollen 患者差，但实验室或美国炎症标志物却没有。根据美国，肿胀的关节在 35% 的病例中表现出活动性滑膜炎，而只有 16% 的触痛关节活动性。与压痛（OR 3.58，P <0.001）相比，基线肿胀更好地预测了 12 个月后同一关节的活动性滑膜炎[优势比 (OR) 6.33，P <0.001]。结论 与 PsA 中的 TJ 相比，SJ 与 US 炎症体征的相关性更密切。一年的随访后，关节肿胀比压痛更能预测美国炎症的迹象。而 TJC 与患者报告的结果 (PROM) 相关性更好，例如患者整体评估 (TJC: r = 0.57; SJC r = 0.39)。pTender 患者的 PROM 和疾病活动评分的结果比 pSwollen 患者差，但实验室或美国炎症标志物却没有。根据美国，肿胀的关节在 35% 的病例中表现出活动性滑膜炎，而只有 16% 的触痛关节活动性。与压痛（OR 3.58，P <0.001）相比，基线肿胀更好地预测了 12 个月后同一关节的活动性滑膜炎[优势比 (OR) 6.33，P <0.001]。结论 与 PsA 中的 TJ 相比，SJ 与 US 炎症体征的相关性更密切。一年的随访后，关节肿胀比压痛更能预测美国炎症的迹象。而 TJC 与患者报告的结果 (PROM) 相关性更好，例如患者整体评估 (TJC: r = 0.57; SJC r = 0.39)。pTender 患者的 PROM 和疾病活动评分的结果比 pSwollen 患者差，但实验室或美国炎症标志物却没有。根据美国，肿胀的关节在 35% 的病例中表现出活动性滑膜炎，而只有 16% 的触痛关节活动性。与压痛（OR 3.58，P <0.001）相比，基线肿胀更好地预测了 12 个月后同一关节的活动性滑膜炎[优势比 (OR) 6.33，P <0.001]。结论 与 PsA 中的 TJ 相比，SJ 与 US 炎症体征的相关性更密切。一年的随访后，关节肿胀比压痛更能预测美国炎症的迹象。