Dactylitis Dactylitis or fusiform swelling of an entire digit is a typical feature of PsA. A number of dactylitis measures are available: • Count of digits with dactylitis (tender and non-tender) • Count of tender dactylitic digits • Semi-quantitative measure: - 0–3 scale of physician-rated severity for affected digits (20 digits in total; maximum overall score of 60) • Leeds Dactylitis Index (LDI) - Objective determination of the presence of dactylitis - Requires dactylometer - a defnition of dactylitis = 10% difference in the ratio of circumference of the affected digit to the contralateral digit. - dactylitis severity is defned by tenderness score (graded 0–3) - LDI =ratio of the circumference of the affected digit to the circumference of the digit on the opposite hand or foot multiplied by a tenderness score (graded 0–3) - recommended by OMERACT for use in clinical trials Leeds Dacylitis Index Axial disease (Assessment of SpondyloArthritis International Society (ASAS) measures as discussed in axial spondyloarthropathy section) Circumference Circumference Final score Finger or Toe Tenderness score (C) involved digit (A) Contralateral digit(or Tables)(B) [{(A/B)-1}x100]xC TOTAL Ref: Helliwell P.S. et al. J Rheumatol 2005; 32:1745-1750. Kaeley GS et al. Semin Arthritis Rheum 2018;48:263–273 14
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