@article {198949, title = {Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study.}, journal = {RMD open}, volume = {7}, year = {2021}, abstract = {

OBJECTIVES: To characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.

METHODS: Cross-sectional study with 24 participating countries. Patients with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or PsA according to their rheumatologist were included. The investigators were asked which diagnosis out of a list of six (axSpA, PsA, pSpA, inflammatory bowel disease-associated SpA, reactive arthritis or juvenile SpA (Juv-SpA)) fitted the patient best. Peripheral manifestations (ie, peripheral joint disease, enthesitis, dactylitis and root joint disease), their localisation and treatments were evaluated.

RESULTS: A total of 4465 patients were included (61\% men, mean age 44.5 years) from four geographic areas: Latin America (n=538), Europe plus North America (n=1677), Asia (n=975) and the Middle East plus North Africa (n=1275). Of those, 78\% had ever suffered from at least one peripheral musculoskeletal manifestation; 57\% had peripheral joint disease, 44\% had enthesitis and 15\% had dactylitis. Latin American had far more often peripheral joint disease (80\%) than patients from other areas. Patients with PsA had predominantly upper limb and small joint involvement (52\%).Hip and shoulder involvement was found in 34\% of patients. The prevalence of enthesitis ranged between 41\% in patients with axSpA and 65\% in patients with Juv-SpA. Dactylitis was most frequent among patients with PsA (37\%).

CONCLUSION: These results suggest that all peripheral features can be found in all subtypes of SpA, and that differences are quantitative rather than qualitative. In a high proportion of patients, axial and peripheral manifestations coincided. These findings reconfirm SpA clinical subtypes are descendants of the same underlying disease, called SpA.

}, author = {L{\'o}pez-Medina, Clementina and Anna Molto and Sieper, Joachim and Duru{\"o}z, Tuncay and Uta Kiltz and Bassel El Zorkany and Najia Hajjaj-Hassouni and Ruben Burgos-Vargas and Jos{\'e} Maldonado-Cocco and Ziade, Nelly and Gavali, Meghna and Victoria Navarro-Compan and Shue-Fen Luo and Monti, Sara and Tae-Jong, Kim and Mitsumasa Kishimoto and F M Pimentel-Santos and Jieruo Gu and Schiotis, Ruxandra and van Gaalen, Floris A and Geher, P{\'a}l and Magrey, Marina and Ib{\'a}{\~n}ez Vodnizza, Sebasti{\'a}n E and Wilson Bautista-Molano and Maksymowych, Walter and Pedro M Machado and Robert Landew{\'e} and van der Heijde, Desir{\'e}e and Maxime Dougados} }