{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:33:46Z","timestamp":1787009626720,"version":"build-2736575974"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T00:00:00Z","timestamp":1637280000000},"content-version":"vor","delay-in-days":322,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Psoriatic nail disease is more common in PsA than in isolated skin psoriasis (PsO). The nail is closely integrated to the DIP joint entheses. US data have shown that those patients with nail disease in PsO are more likely to have systemic enthesitis. We examined whether there was a relationship between nail disease, DIP enthesitis and systemic enthesitis in established PsA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty-six PsA participants with nail disease underwent US scanning of the nail unit and the DIP entheses along with peripheral entheseal sites according to the Madrid sonographic enthesitis index (MASEI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At the finger level, there was a mild to moderate correlation between nail US changes and both clinical nail disease and DIP enthesis changes (DIP US) [Spearman correlation (rS) = 0.30, P &amp;lt; 0.001 and rS = 0.16, P &amp;lt; 0.001, respectively]. At the patient level, there was a moderate correlation between the nail US score and nail psoriasis severity index score and DIP US (rS = 0.33, P = 0.024 and rS = 0.43, P = 0.003, respectively). At the patient level, there was also a positive correlation between a higher nail US score and the active peripheral enthesitis score (MASEI-active) (rS = 0.35, P = 0.018). When power Doppler was part of nail US score, similar results were demonstrated at both the finger and patient levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study has demonstrated the utility of nail US imaging and the close relationship, on scanning, between the DIP entheses and the nail unit. In PsA, we have seen a correlation between active US changes at the nail and peripheral enthesitis, which requires further analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov, https:\/\/clinicaltrials.gov, NCT03955861.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/rap\/rkab088","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T14:17:29Z","timestamp":1638886649000},"source":"Crossref","is-referenced-by-count":11,"title":["The relationship between the nail and systemic enthesitis in psoriatic arthritis"],"prefix":"10.1093","volume":"5","author":[{"given":"Ashley","family":"Elliott","sequence":"first","affiliation":[{"name":"Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen\u2019s University Belfast"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Pendleton","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Musgrave Park Hospital, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Wright","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Musgrave Park Hospital, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Rooney","sequence":"additional","affiliation":[{"name":"Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen\u2019s University Belfast"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,19]]},"reference":[{"key":"2021120719170416500_rkab088-B1","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":"2021120719170416500_rkab088-B2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/j.1468-3083.2009.03363.x","article-title":"Enthesitis: an autoinflammatory lesion linking nail and joint involvement in psoriatic disease","volume":"23","author":"McGonagle","year":"2009","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2021120719170416500_rkab088-B3","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":"2021120719170416500_rkab088-B4","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1111\/bjd.13272","article-title":"Nail involvement as a predictor of concomitant psoriatic 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Med"},{"key":"2021120719170416500_rkab088-B11","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1093\/rheumatology\/kes014","article-title":"Development of a preliminary US power Doppler composite score for monitoring treatment in PsA","volume":"51","author":"Gutierrez","year":"2012","journal-title":"Rheumatology (Oxford)"},{"key":"2021120719170416500_rkab088-B12","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":"2021120719170416500_rkab088-B13","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.1111\/jdv.15035","article-title":"Subclinical enthesopathy of extensor digitorum tendon is highly prevalent and associated with clinical and ultrasound alterations of the adjacent fingernails in patients with psoriatic disease","volume":"32","author":"Moya Alvarado","year":"2018","journal-title":"J Eur Acad Dermatology Venereol"},{"key":"2021120719170416500_rkab088-B14","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.semarthrit.2017.05.002","article-title":"Ultrasound entheseal abnormalities at the distal interphalangeal joints and clinical nail involvement in patients with psoriasis and psoriatic arthritis, supporting the nail-enthesitis theory","volume":"47","author":"Acosta-Felquer","year":"2017","journal-title":"Semin Arthritis Rheum"},{"key":"2021120719170416500_rkab088-B15","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1007\/s10067-019-04748-2","article-title":"Nail ultrasonography for psoriatic arthritis and psoriasis patients: a systematic literature review","volume":"39","author":"Fassio","year":"2020","journal-title":"Clin 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