INTRODUCTION
Psoriatic arthritis (PsA) is a chronic, immune mediated, inflammatory musculoskeletal diseasecharacterized by inflammation of not only articular sites but also extra articular sites like entheses, tendons, fingers, toes and skin.(1)Pain is a major concern for patients with PsA.(2) It may be a nociceptive type of pain (caused by the inflammatory damage and tissue destruction), a neuropathic (due to augmented central chronic pain processing) or even mixed type may be present.(3)The different pain mechanisms in PsA patients may lead to misinterpretation of the disease activity and accordingly excessive therapy.(4)
AIM OF THE WORK
To study pain in PsA patients andits relation to the disease activity by clinical and ultrasound scores.
SUBJECTS AND METHOD
Thirty patients diagnosed according to CASPAR criteria as PsA were enrolled in the current study. Patients with other neuropathic disorders (e.g. diabetic neuropathy) or other rheumatic conditions were excluded.
All patients were subjected to clinical assessment of the musculoskeletal system and skin disease assessment. Pain was assessed by pain NRS, Swollen to Tender joint Ratio (STR), Manual Tender Point Count (TPC), Widespread Pain Index (WPI) and Pain Detect Questionnaire (PDQ). The disease activity was assessed clinically by using the Disease Activity index for Psoriatic Arthritis (DAPSA), the Composite Psoriatic Disease Activity Index (CPDAI) and the Psoriatic Arthritis Disease Activity Score (PASDAS) and ultrasonographically by PsA-Son13 score.