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The structure and function of the AT in PsA, and the prevalence of mid-portion pathology, is unknown. To compare the structure and function of the AT in people with PsA with self-reported AT pain (PsA\u2009+\u2009AT), PsA without self-reported AT pain (PsA-AT) and healthy controls. A cross-sectional, observational study was conducted. The ATs were assessed by clinical and US examination (B-mode and Power Doppler), performance-based testing (bilateral heel raise test (HRT) and 10\u00a0m walk test), and patient-reported outcome measures (PROMs) (including the Victorian Institute of Sport Assessment-Achilles [VISA-A]). Between-group differences were described using descriptive statistics, Chi-squared testing, parametric (1-way ANOVA) and non-parametric (Mann-Whitney or Kruskal-Wallis) testing. 22 PsA (11 per group) and 11 healthy control participants who were comparable in terms of sex, age, and BMI (PsA-AT\u2009=\u2009longer PsA disease duration) were recruited. VISA-A scores were significantly worse in the PsA\u2009+\u2009AT group compared to the PsA-AT group and healthy controls (<jats:italic>p\u2009&lt;\u20090.001<\/jats:italic>). Inflammatory US features were significantly more prevalent in the PsA\u2009+\u2009AT group (<jats:italic>p\u2009&lt;\u20090.001<\/jats:italic>). Mid-portion AT pathology was observed in the PsA\u2009+\u2009AT group, irrespective of entheseal disease. Clinical examination alone missed 5\/7 cases of \u2018active\u2019 US-confirmed AT enthesitis. AT functional deficits were significant in the PsA\u2009+\u2009AT group and both PsA groups had lower HRT repetition rates and walked slower compared to healthy controls. Less than 1\/3 of the PsA\u2009+\u2009AT group had received podiatry or physiotherapy care. Significant differences in the structure and function of the AT in PsA were noted. Despite management in line with current guidance, AT pain appears to persist and can result in severe functional impairment.<\/jats:p>","DOI":"10.1007\/s00296-024-05629-x","type":"journal-article","created":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T07:02:10Z","timestamp":1717830130000},"page":"1469-1479","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Significant functional impairment and disability in individuals with psoriatic arthritis and Achilles tendon pain: a cross-sectional observational study"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2783-1106","authenticated-orcid":false,"given":"Aimie","family":"Patience","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9243-170X","authenticated-orcid":false,"given":"Martijn","family":"Steultjens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1802-7311","authenticated-orcid":false,"given":"Stefan","family":"Siebert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1611-7193","authenticated-orcid":false,"given":"Gordon","family":"Hendry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,8]]},"reference":[{"key":"5629_CR1","doi-asserted-by":"publisher","first-page":"1685","DOI":"10.1002\/acr.23174","volume":"69","author":"A Polachek","year":"2016","unstructured":"Polachek A, Mmath SL, Chandran V, Gladman DD (2016) Clinical Enthesitis in a prospective longitudinal psoriatic arthritis cohort: incidence, prevalence, characteristics, and Outcome. 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