Ultraschall Med 2021; 42(06): 643-651
DOI: 10.1055/a-1168-6636
Original Article

How Variable Is the Volar Subcutaneous Tissue of the Digits on B-Mode and Color Doppler Ultrasound in Non-Psoriatic Individuals and Could It Be Included in a Dactylitis Score?

Wie variabel ist das volare subkutane Gewebe der Digiti beim B-Modus- und Farbdoppler-Ultraschall bei Nicht-Psoriatikern und könnte es in einen Daktylitis-Score einbezogen werden?
Ana Rebollo-Giménez
1   Department of Rheumatology, Ciudad Real General University Hospital, Ciudad Real, Spain
2   Department of Rheumatology, Joint and Bone Research Unit, Fundacion Jimenez Diaz University Hospital, Madrid, Spain
,
Lina Martínez-Estupiñán
2   Department of Rheumatology, Joint and Bone Research Unit, Fundacion Jimenez Diaz University Hospital, Madrid, Spain
,
Otto Olivas-Vergara
2   Department of Rheumatology, Joint and Bone Research Unit, Fundacion Jimenez Diaz University Hospital, Madrid, Spain
,
Gema Fuensalida-Novo
2   Department of Rheumatology, Joint and Bone Research Unit, Fundacion Jimenez Diaz University Hospital, Madrid, Spain
,
Jesús Garrido
3   Department of Social Psychology and Methodology, Faculty of Psychology, Autonoma University of Madrid, Spain
,
Andrés Mejía
3   Department of Social Psychology and Methodology, Faculty of Psychology, Autonoma University of Madrid, Spain
,
Gabriel Herrero-Beaumont
2   Department of Rheumatology, Joint and Bone Research Unit, Fundacion Jimenez Diaz University Hospital, Madrid, Spain
,
Esperanza Naredo
2   Department of Rheumatology, Joint and Bone Research Unit, Fundacion Jimenez Diaz University Hospital, Madrid, Spain
› Institutsangaben

Abstract

Background Digital subcutaneous tissue (SCT) changes are involved in dactylitis, a hallmark feature of psoriatic arthritis (PsA). There are no studies on the ultrasound (US) characteristics of the digital SCT in the general population.

Objectives To investigate the variability in US-measured thickness (TH) and color Doppler (CD)-detected blood flow of the SCT of the volar aspects of the fingers in a non-psoriatic population and to investigate the impact of the scanning method and demographics and clinical features on these measurements.

Methods SCT TH and semiquantitative (SQD) and quantitative (QD) Doppler signals were measured in the bilateral second finger at the proximal and middle phalanges in 81 non-psoriatic volunteers [49 female, 32 men; 18–78 years]. Two scanning methods with and without (thick gel layer interposition) probe-skin contact were used. Demographics and clinical features were collected.

Results There was high variability of SCT TH and Doppler measurements between individuals. All US measurements obtained without probe-skin contact were significantly greater than their corresponding measurements obtained with the probe contacting the skin (p < 0.001). SCT TH was positively related to dominant hand, age, masculine gender, weight, height, body mass index, and alcohol consumption while Doppler measurements were positively related to age and non-dominant hand.

Conclusions US-measured SCT thickness and Doppler-detected SCT blood flow of the volar aspect of the fingers seem to be highly variable in the non-psoriatic population as well as highly dependent on the US scanning method. This variability is of utmost importance for assessing dactylitis in PsA.

Zusammenfassung

Hintergrund Veränderungen des subkutanen Gewebes (subcutaneous tissue, SCT) der Finger sind an der Daktylitis beteiligt, einem charakteristischen Zeichen der Psoriasis-Arthritis (PsA). Es gibt keine Studien über die Ultraschall (US) -Merkmale des digitalen SCT in der Allgemeinbevölkerung.

Ziel Untersuchung der Variabilität der im US gemessenen Dicke (TH) und des mit Farbdoppler (CD) gemessenen Blutflusses des SCT der volaren Seiten der Finger in einer nicht psoriatischen Population sowie die Untersuchung des Einflusses der Untersuchungsmethode und demografischer und klinischer Parameter auf diese Messungen.

Methoden SCT-TH und semiquantitative (SQD) und quantitative (QD) Dopplersignale wurden bilateral am zweiten Finger an den proximalen und mittleren Fingergliedern bei 81 nicht psoriatischen Freiwilligen (49 weiblich, 32 männlich; 18–78 Jahre) bestimmt. Es wurden 2 Untersuchungsmethoden verwendet: 1 eine mit Sonden-Haut-Kontakt sowie eine ohne (durch Einfügen einer dicken Gelschicht). Demografische und klinische Merkmale wurden erhoben.

Ergebnisse Es gab eine hohe Variabilität der SCT-TH- und Doppler-Messungen zwischen den Individuen. Alle US-Messungen ohne Sonden-Haut-Kontakt waren signifikant größer als die entsprechenden Messungen, die mit Sonden-Haut-Kontakt durchgeführt wurden (p < 0,001). Es gab eine positive Relation der SCT-TH mit der dominanten Hand, dem Alter, dem männlichen Geschlecht, dem Gewicht, der Größe, dem Body-Mass-Index und dem Alkoholkonsum, während die Doppler-Messungen eine positive Relation zum Alter und der nicht dominanten Hand aufwiesen.

Schlussfolgerungen Die im US gemessene SCT-Dicke und der im Doppler detektierte SCT-Blutfluss der volaren Seiten der Finger scheinen in der nicht psoriatischen Bevölkerung sehr variabel zu sein und hängen stark von der US-Untersuchungsmethode ab. Diese Variabilität ist für die Beurteilung der Daktylitis bei PsA von größter Bedeutung.



Publikationsverlauf

Eingereicht: 30. Oktober 2019

Angenommen: 13. April 2020

Artikel online veröffentlicht:
20. Mai 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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