Introducere. Prezenţa cristalelor de monourat în lichidul sinovial determină degradarea mai rapidă a articulaţiilor, astfel prevenţia dezvoltării acestora prin monitorizare de laborator a nivelului de acid uric, determinarea cristalelor prin microscopia lichidului sinovial şi tratament hipouri- cemiant va avea impact asupra evoluţiei formei destructive a artritei psoriazice (APs). Obiective: Determinarea corelaţiei dintre prezenţa cristalelor de monourat în lichidul sinovial al pacienţilor cu APs şi dependenţa acestora de activitatea bolii. Metode: A fost analizat şi comparat lichidul sinovial de la 60 pacienţi cu APs, cu activitate diferită, cu cel de la 30 pacienţi cu gonartrită. Rezultate: Prezenţa cristalelor a fost observată la 28,33% dintre pacienţii cu APs şi la nici un pacient cu gonartrită (pcO.OOl). S-au determinat: cristale de urat monosodic (74,80%) şi cristale de pirofosfat de calciu (23,54%). Prezenţa cristalelor în lichidul sinovial al pacienţilor şi APs a fost asociată cu o activitate crescută a bolii conform DAPSA (OR [17,73]: IS 95% 7,07 - 47,15) şi activităţii APs (OR [14,93], IS 95%; 5,7-41,1), cu dizabili- tăţi severe conform HAQ (OR [12,56], IS 95%; 5,2-35,11) şi cu durere severă pe SAV (OR [24,153,] IS 95%; 37,7-327,5). Concluzie: Examinarea lichidului sinovial ar trebui să fie inclusă în managementul pacienţilor cu artrită psoriazică cu boala activă, pentru a ajuta la determinarea necesităţii unui tratament hipouricemiant.
Introduction. The presence of monourate crystals in synovial fluid causes faster degradation of joints, so preventing their development by laboratory monitoring of uric acid levels, determination of crystals by synovial fluid microscopy and hypouricemiant treatment will have an impact on the evolution of the destructive form of psoriatic arthritis (PsA). Objectives. To determine the correlation between the presence of monourate crystals in the synovial fluid of patients with PsA and their dependence on disease activity. Material and methods. Synovial fluid from 60 PsA patients with different activity was analyzed and compared with that from 30 patients with gonarthritis. Results. The presence of crystals was observed in 28.33% of patients with PsA and no patients with gonarthritis (p<0.001). Monosodium urate crystals (74.80%) and calcium pyrophosphate crystals (23.54%) were determined. The presence of crystals in patients' synovial fluid and PsA was associated with increased disease activity according to DAPSA (OR [17,73]: IS 95% 7.07 - 47,15) and PsA activity (OR [14,93], IS 95%; 5.7- 41,1), with severe disability according to HAQ (OR [12,56], IS 95%; 5.2-35,11) and severe pain on SAV (OR [24,153,] IS 95%; 37.7-327.5). Conclusion. Synovial fluid examination should be included in the management of psoriatic arthritis patients with active disease to help determine the need for hypouricemiant treatment.