INCIDENCE OF OSTEOPERIOSTITIS OF THE GREAT TOE IN PSORIATIC-ARTHRITIS

Objective. To assess the incidence of osteoperiostitis of the distal p halanx of the great toe in psoriatic arthritis (PsA). Methods, One tho usand great toes (202 of PsA, 44 of cutaneous psoriasis, 274 of low ba ck pain patients, 296 of rheumatoid arthritis, 136 of spondyloarthropa thy, and 48 of connective tissue diseases) were studied for osteoperio stitis of the distal phalanx of the great toe (slight, moderate, or se vere), destructive joint lesions of the feet, nail dystrophy, fungal i nfection, and HLA-B type (patients with PsA), Results. Osteoperiostiti s was observed in 92 great toes. Moderate and severe osteoperiostitis were observed only in PsA. Osteoperiostitis was statistically more fre quent in PsA (53/202, 26.2%, especially in those with onychosis: 20/41 , 48.8%) than in other groups (39/798, 4.9%) (p<0.01). In PsA, osteope riostitis was more frequent in patients with nail dystrophy (20/41, 48 .8%) than in patients without (33/161, 20.5%) (p<0.05). Fungal infecti on of the nail and HLA haplotype were not associated with osteoperiost itis, In patients with PsA, osteoperiostitis was associated with destr uctive joint lesions of the feet. Conclusion. Osteoperiostitis of the distal phalanx of the great toe is an enthesopathy evocative of PsA.