Combining ultrasound with other triage tools may aid PsA diagnosis
medwireNews: Using musculoskeletal ultrasound alongside other triage modalities may improve the detection of psoriatic arthritis (PsA) among patients with psoriasis and musculoskeletal symptoms, researchers report.
Lihi Eder (University of Toronto, Ontario, Canada) and team’s study involved 203 individuals referred to a rapid access clinic in Toronto who were assessed using three central triage tools – physiotherapist evaluation, musculoskeletal ultrasound, and PsA screening questionnaires – before having their disease status classified by a rheumatologist. In all, 8.9% of participants received a rheumatologist diagnosis of PsA, while 23.6% were classified as “possibly PsA.”
Eder et al say that none of the individual triage tools had significantly better performance than the others for identifying people with definite or possible PsA, and the sensitivities and specificities of the triage tools “ranged widely,” from 56% to 89% and 44% to 79%, respectively.
However, combining ultrasound with the other modalities improved diagnostic performance, with ultrasound plus the Psoriasis Epidemiology Screening Tool questionnaire being “one of the optimal combinations,” note the researchers. The combination resulted in 71% sensitivity and 81% specificity.
“Further research needs to be done on how the central screening modalities affect wait times and short and long-term patient outcomes and if it is feasible on a larger scale,” concludes the team in Arthritis Care & Research.
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