{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T01:33:50Z","timestamp":1782783230273,"version":"3.54.5"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T00:00:00Z","timestamp":1636070400000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005614","name":"Biogen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005614","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The objectives were to evaluate the methodological and reporting quality of ultrasound (US) studies of Achilles enthesitis in people with psoriatic arthritis (PsA), to identify the definitions and scoring systems adopted and to estimate the prevalence of ultrasound features of Achilles enthesitis in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic literature review was conducted using the AMED, CINAHL, MEDLINE, ProQuest and Web of Science databases. Eligible studies had to measure US features of Achilles enthesitis in people with PsA. Methodological quality was assessed using a modified Downs and Black Quality Index tool. US protocol reporting was assessed using a checklist informed by the European League Against Rheumatism (EULAR) recommendations for the reporting of US studies in rheumatic and musculoskeletal diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen studies were included. One study was scored as high methodological quality, 9 as moderate and 5 as low. Significant heterogeneity was observed in the prevalence, descriptions, scoring of features and quality of US protocol reporting. Prevalence estimates (% of entheses) reported included hypoechogenicity [mean 5.9% (s.d. 0.9)], increased thickness [mean 22.1% (s.d. 12.2)], erosions [mean 3.3% (s.d. 2.5)], calcifications [mean 42.6% (s.d. 15.6)], enthesophytes [mean 41.3% (s.d. 15.6)] and Doppler signal [mean 11.8% (s.d. 10.1)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The review highlighted significant variations in prevalence figures that could potentially be explained by the range of definitions and scoring criteria available, but also due to the inconsistent reporting of US protocols. Uptake of the EULAR recommendations and using the latest definitions and validated scoring criteria would allow for a better understanding of the frequency and severity of individual features of pathology.<\/jats:p><\/jats:sec>","DOI":"10.1093\/rap\/rkab056","type":"journal-article","created":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T14:27:32Z","timestamp":1636122452000},"page":"ii19-ii34","source":"Crossref","is-referenced-by-count":6,"title":["Ultrasound features of Achilles enthesitis in psoriatic arthritis: a systematic review"],"prefix":"10.1093","volume":"5","author":[{"given":"Aimie","family":"Patience","sequence":"first","affiliation":[{"name":"Musculoskeletal Health Research Group, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn P","family":"Steultjens","sequence":"additional","affiliation":[{"name":"Musculoskeletal Health Research Group, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon J","family":"Hendry","sequence":"additional","affiliation":[{"name":"Musculoskeletal Health Research Group, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,5]]},"reference":[{"key":"2021110514270720300_rkab056-B1","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/978-1-4419-0298-6_4","article-title":"The enthesisorgan concept and its relevance to the spondyloarthropathies","volume":"649","author":"Benjamin","year":"2009","journal-title":"Adv Exp Med Biol"},{"key":"2021110514270720300_rkab056-B2","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1002\/acr.23174","article-title":"Clinical enthesitis in a prospective longitudinal psoriatic arthritis cohort: incidence, prevalence, characteristics, and outcome","volume":"69","author":"Polachek","year":"2017","journal-title":"Arthritis Care Res"},{"key":"2021110514270720300_rkab056-B3","doi-asserted-by":"crossref","first-page":"651","DOI":"10.3889\/oamjms.2017.070","article-title":"Ultrasonographic enthesopathy and disease activity in psoriatic arthritis","volume":"5","author":"Ahmed","year":"2017","journal-title":"Open Access Maced J Med Sci"},{"key":"2021110514270720300_rkab056-B4","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1007\/s10067-018-04411-2","article-title":"Perspectives of patients and health professionals on the experience of living with psoriatic arthritis-related foot problems: a qualitative investigation","volume":"38","author":"Carter","year":"2019","journal-title":"Clin Rheumatol"},{"key":"2021110514270720300_rkab056-B5","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1002\/art.39573","article-title":"Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 treatment recommendations for psoriatic arthritis","volume":"68","author":"Coates","year":"2016","journal-title":"Arthritis Rheumatol"},{"key":"2021110514270720300_rkab056-B6","doi-asserted-by":"crossref","first-page":"487","DOI":"10.3389\/fmed.2020.00487","article-title":"Ultrasound imaging in psoriatic arthritis: what have we learnt in the last five years?","volume":"7","author":"Dubash","year":"2020","journal-title":"Front Med"},{"key":"2021110514270720300_rkab056-B7","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.1136\/annrheumdis-2018-213609","article-title":"Reliability of a consensus-based ultrasound definition and scoring for enthesitis in spondyloarthritis and psoriatic arthritis: an OMERACT US initiative","volume":"77","author":"Balint","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"2021110514270720300_rkab056-B8","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1002\/art.23568","article-title":"Measuring clinical enthesitis in psoriatic arthritis: assessment of existing measures and development of an instrument specific to psoriatic arthritis","volume":"59","author":"Healy","year":"2008","journal-title":"Arthritis Rheum"},{"key":"2021110514270720300_rkab056-B9","doi-asserted-by":"crossref","first-page":"139","DOI":"10.55563\/clinexprheumatol\/u8qc6c","article-title":"Ultrasound assessment, unlike clinical assessment, reflects enthesitis in patients with psoriatic arthritis","volume":"39","author":"Yamada","year":"2021","journal-title":"Clin Exp Rheumatol"},{"key":"2021110514270720300_rkab056-B10","doi-asserted-by":"crossref","first-page":"e000486","DOI":"10.1136\/rmdopen-2017-000486","article-title":"Achilles enthesitis defined by ultrasound is not associated with clinical enthesitis in patients with psoriatic arthritis","volume":"3","author":"Michelsen","year":"2017","journal-title":"RMD Open"},{"key":"2021110514270720300_rkab056-B11","doi-asserted-by":"crossref","first-page":"904","DOI":"10.3899\/jrheum.171411","article-title":"Ultrasonographic and clinical assessment of peripheral enthesitis in patients with psoriatic arthritis, psoriasis, and fibromyalgia syndrome: the ULISSE study","volume":"46","author":"Macchioni","year":"2019","journal-title":"J Rheumatol"},{"key":"2021110514270720300_rkab056-B12","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1136\/ard.61.10.905","article-title":"Ultrasonography of entheseal insertions in the lower limb in spondyloarthropathy","volume":"61","author":"Balint","year":"2002","journal-title":"Ann Rheum Dis"},{"key":"2021110514270720300_rkab056-B13","first-page":"2485","article-title":"Musculoskeletal ultrasound including definitions for ultrasonographic pathology","volume":"32","author":"Wakefield","year":"2005","journal-title":"J Rheumatol"},{"key":"2021110514270720300_rkab056-B14","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1136\/ard.2007.084251","article-title":"Validity of enthesis ultrasound assessment in spondyloarthropathy","volume":"68","author":"De Miguel","year":"2009","journal-title":"Ann Rheum Dis"},{"key":"2021110514270720300_rkab056-B15","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1002\/acr.22191","article-title":"Defining enthesitis in spondyloarthritis by ultrasound: results of a Delphi process and of a reliability reading exercise","volume":"66","author":"Terslev","year":"2014","journal-title":"Arthritis Care Res"},{"key":"2021110514270720300_rkab056-B16","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1136\/annrheumdis-2020-219816","article-title":"EULAR recommendations for the reporting of ultrasound studies in rheumatic and musculoskeletal diseases (RMDs)","volume":"80","author":"Costantino","year":"2021","journal-title":"Ann Rheum Dis"},{"key":"2021110514270720300_rkab056-B17","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"2021110514270720300_rkab056-B18","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1136\/jech.52.6.377","article-title":"The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions","volume":"52","author":"Downs","year":"1998","journal-title":"J Epidemiol Community Health"},{"key":"2021110514270720300_rkab056-B19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta4340","article-title":"A systematic review of comparisons of effect sizes derived from randomised and non-randomised studies","volume":"4","author":"MacLehose","year":"2000","journal-title":"Health Technol Assess"},{"key":"2021110514270720300_rkab056-B20","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.semarthrit.2015.03.001","article-title":"The assessment of lesions of the Achilles tendon by ultrasound imaging in inflammatory arthritis: A systematic review and meta-analysis","volume":"45","author":"Carroll","year":"2015","journal-title":"Semin Arthritis Rheum"},{"key":"2021110514270720300_rkab056-B21","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1002\/art.24369","article-title":"How to evaluate and improve the reliability of power Doppler ultrasonography for assessing enthesitis in spondylarthritis","volume":"61","author":"D\u2019Agostino","year":"2009","journal-title":"Arthritis Care Res"},{"key":"2021110514270720300_rkab056-B22","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1002\/art.10812","article-title":"Assessment of peripheral enthesitis in the spondylarthropathies by ultrasonography combined with power Doppler: a cross-sectional study","volume":"48","author":"D\u2019Agostino","year":"2003","journal-title":"Arthritis Rheum"},{"key":"2021110514270720300_rkab056-B23","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1136\/ard.57.5.268","article-title":"Ultrasonography in rheumatology: an evolving technique","volume":"57","author":"Grassi","year":"1998","journal-title":"Ann Rheum Dis"},{"key":"2021110514270720300_rkab056-B24","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1148\/radiology.155.3.3890011","article-title":"Ultrasound examination of the hand","volume":"155","author":"Fornage","year":"1985","journal-title":"Radiology"},{"key":"2021110514270720300_rkab056-B25","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/978-1-4612-3482-1_4","volume-title":"Ultrasonography of muscles and tendons","author":"Fornage","year":"1989"},{"key":"2021110514270720300_rkab056-B26","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1080\/030097400750041415","article-title":"Ultrasound evaluation of plantar fasciitis","volume":"29","author":"Tsai","year":"2000","journal-title":"Scand J Rheumatol"},{"key":"2021110514270720300_rkab056-B27","first-page":"159","article-title":"Ultrasonography in the early diagnosis of psoriasis-associated enthesopathy","volume":"27","author":"De Filippis","year":"2005","journal-title":"Int J Tissue React"},{"key":"2021110514270720300_rkab056-B28","first-page":"349","article-title":"Ultrasound imaging for the rheumatologist IX. Ultrasound imaging in spondyloarthritis","volume":"2525","author":"Riente","year":"2007","journal-title":"Clin Exp Rheumatol"},{"key":"2021110514270720300_rkab056-B29","doi-asserted-by":"crossref","first-page":"3761","DOI":"10.1002\/art.22190","article-title":"Presence of significant synovitis in rheumatoid arthritis patients with disease-modifying antirheumatic drug-induced clinical remission: Evidence from an imaging study may explain structural progression","volume":"54","author":"Brown","year":"2006","journal-title":"Arthritis Rheum"},{"key":"2021110514270720300_rkab056-B30","first-page":"219","article-title":"Ultrasound detects occult entheseal involvement in early psoriatic arthritis independently of clinical features and psoriasis severity","volume":"31","author":"Bandinelli","year":"2013","journal-title":"Clin Exp Rheumatol"},{"key":"2021110514270720300_rkab056-B31","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.ejr.2019.04.005","article-title":"The incremental value of ultrasound in detection of subclinical peripheral enthesitis in patients with spondyloarthritis","volume":"42","author":"ElMallah","year":"2020","journal-title":"Egypt Rheumatol"},{"key":"2021110514270720300_rkab056-B32","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1080\/03009740310003721","article-title":"Sonographic study of calcaneal entheses in erosive osteoarthritis, nodal osteoarthritis, rheumatoid arthritis and psoriatic arthritis","volume":"32","author":"Falsetti","year":"2003","journal-title":"Scand J Rheumatol"},{"key":"2021110514270720300_rkab056-B33","doi-asserted-by":"crossref","first-page":"7","DOI":"10.4137\/CMAMD.S4461","article-title":"Value of entheseal ultrasonography and serum cartilage oligomeric matrix protein in the preclinical diagnosis of psoriatic arthritis","volume":"3","author":"Farouk","year":"2010","journal-title":"Clin Med Insights Arthritis Musculoskelet Disord"},{"key":"2021110514270720300_rkab056-B34","first-page":"S31","article-title":"Assessment of enthesis in patients with psoriatic arthritis and fibromyalgia using clinical examination and ultrasound","volume":"38(Suppl 123","author":"Fiorenza","year":"2020","journal-title":"Clin Exp Rheumatol"},{"key":"2021110514270720300_rkab056-B35","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1002\/acr.21733","article-title":"Is there subclinical enthesitis in early psoriatic arthritis? A clinical comparison with power doppler ultrasound","volume":"64","author":"Freeston","year":"2012","journal-title":"Arthritis Care Res"},{"key":"2021110514270720300_rkab056-B36","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1080\/030097400750001806","article-title":"Sonographic analysis of the ankle in patients with psoriatic arthritis","volume":"29","author":"Galluzzo","year":"2000","journal-title":"Scand J Rheumatol"},{"key":"2021110514270720300_rkab056-B37","first-page":"29","article-title":"Entheseal power doppler ultrasonography: a comparison of psoriatic arthritis and fibromyalgia","volume":"39","author":"Marchesoni","year":"2012","journal-title":"J Rheumatol"},{"key":"2021110514270720300_rkab056-B38","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1007\/s00296-016-3562-8","article-title":"An ultrasonographic study of enthesis in early psoriatic arthritis patients naive to traditional and biologic DMARDs treatment","volume":"36","author":"Perrotta","year":"2016","journal-title":"Rheumatol Int"},{"key":"2021110514270720300_rkab056-B39","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1080\/03009742.2017.1393695","article-title":"Modification of a sonographic enthesitis score to differentiate between psoriatic arthritis and young healthy volunteers","volume":"47","author":"Wervers","year":"2018","journal-title":"Scand J Rheumatol"},{"key":"2021110514270720300_rkab056-B40","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3109\/03009742.2012.747626","article-title":"Achilles tendon biomechanics in psoriatic arthritis patients with ultrasound proven enthesitis","volume":"42","author":"Woodburn","year":"2013","journal-title":"Scand J Rheumatol"},{"key":"2021110514270720300_rkab056-B41","first-page":"7701","article-title":"Imaging features and diagnosis of early psoriatic arthritis with lower limb entheseal abnormalities in psoriasis patients under high frequency ultrasonography","volume":"12","author":"Xie","year":"2019","journal-title":"Int J Clin Exp Med"},{"key":"2021110514270720300_rkab056-B42","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s10067-014-2753-5","article-title":"Ultrasound assessment of enthesis thickening in psoriatic arthritis patients treated with adalimumab compared to methotrexate","volume":"35","author":"Litinsky","year":"2016","journal-title":"Clin Rheumatol"},{"key":"2021110514270720300_rkab056-B43","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.3899\/jrheum.180782","article-title":"Association of physical activity and medication with enthesitis on ultrasound in psoriatic arthritis","volume":"46","author":"Wervers","year":"2019","journal-title":"J Rheumatol"},{"key":"2021110514270720300_rkab056-B44","doi-asserted-by":"crossref","first-page":"2665","DOI":"10.1002\/art.21972","article-title":"Classification criteria for psoriatic arthritis: development of new criteria from a large international study","volume":"54","author":"Taylor","year":"2006","journal-title":"Arthritis Rheum"},{"key":"2021110514270720300_rkab056-B45","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/0049-0172(73)90035-8","article-title":"Psoriatic arthritis","volume":"3","author":"Moll","year":"1973","journal-title":"Semin Arthritis Rheum"},{"key":"2021110514270720300_rkab056-B46","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.semarthrit.2017.12.008","article-title":"Enthesitis: a hallmark of psoriatic arthritis","volume":"48","author":"Kaeley","year":"2018","journal-title":"Semin Arthritis Rheum"},{"key":"2021110514270720300_rkab056-B47","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1136\/annrheumdis-2011-200017","article-title":"Do non-steroidal anti-inflammatory drugs have a significant effect on detection and grading of ultrasound-detected synovitis in patients with rheumatoid arthritis? Results from a randomised study","volume":"70","author":"Zayat","year":"2011","journal-title":"Ann Rheum Dis"},{"key":"2021110514270720300_rkab056-B48","doi-asserted-by":"crossref","first-page":"6492597","DOI":"10.1155\/2016\/6492597","article-title":"Achilles tendinopathy: current concepts about the basic science and clinical treatments","volume":"2016","author":"Li","year":"2016","journal-title":"BioMed Res Int"},{"key":"2021110514270720300_rkab056-B49","doi-asserted-by":"crossref","first-page":"e000699","DOI":"10.1136\/bmjsem-2019-000699","article-title":"Staging Achilles tendinopathy using ultrasound imaging: The development and investigation of a new ultrasound imaging criteria based on the continuum model of tendon pathology","volume":"6","author":"Matthews","year":"2020","journal-title":"BMJ Open Sport Exerc Med"},{"key":"2021110514270720300_rkab056-B50","first-page":"408","article-title":"Ultrasound pathology of the entheses in an age and gender stratified sample of healthy adult subjects: a prospective cross-sectional frequency study","volume":"37","author":"Guldberg-M\u00f8ller","year":"2019","journal-title":"Clin Exp Rheumatol"}],"container-title":["Rheumatology Advances in Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/rheumap\/article-pdf\/5\/Supplement_2\/ii19\/41090510\/rkab056.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/rheumap\/article-pdf\/5\/Supplement_2\/ii19\/41090510\/rkab056.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T08:59:21Z","timestamp":1699779561000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/rheumap\/article\/5\/Supplement_2\/ii19\/6421484"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,1]]},"references-count":50,"journal-issue":{"issue":"Supplement_2","published-print":{"date-parts":[[2021,11,5]]}},"URL":"https:\/\/doi.org\/10.1093\/rap\/rkab056","relation":{},"ISSN":["2514-1775"],"issn-type":[{"value":"2514-1775","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,11,1]]},"published":{"date-parts":[[2021,11,1]]}}}