Background Enthesitis and dactylitis are characteristic features of psoriatic arthritis and the others spondyloarthropathies. Both may appear from the onset of the disease.
Objectives To analize the clinical characteristic of a population of patients with psoriatic arthritis who presented enthesitis and dactylitis as their only clinical symptoms at the onset of the disease.
Methods We have studied a group of 204 patients diagnosed with psoriatic arthritis following the Moll and Wright criteria, selecting only those who expressed either Enthesitis or dactylitis as initial symptoms of the disease.
Results Twenty-eight patients (14%) proved to have Enthesitis or dactylitis 21 enthesitis, 7 dactylitis and 1 Enthesitis and dactylitis as disease onset, and seventeen were men (60.7%). The mean age of psoriatic arthritis onset was 38 years (range: 17–58). The mean time from Enthesitis and dactylitis onset and the Moll and Wright criteria was 6 months (range: 1–180). Enthesitis was most frequent in achilles tendon (81%) and the plantar fascia (72.7%). Twenty patients (71.4%) presented arthritis involving peripheral joints, 4 (14.3%) presented and axial skeleton distribution, and the remaining (14.3%) showed a mixed peripheral and axial distribution.
Conclusion Enthesitis and dactylitis are initial clinical features of psoriatic arthritis, even though the majority of the patients with these symptoms at the beginning of the disease evolve towards a peripheral arthritis pattern.
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