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Spinal radiographs were graded with the modified Stoke AS Spinal Score (mSASSS). Associations between US damage score and mSASSS were assessed with negative binomial regression analyses overall, by sex and by age quartiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>US was performed in 173 patients, 54% males, with a mean (SD) age of 55 (13) years and symptom duration of 29 (13) years. The prevalence of any structural US lesion was 92%. The US damage score was higher in males than females (mean (SD) 4.7 (3.0) versus 3.3 (2.4), p&lt;0.001) and increased significantly with age, as did mSASSS. Univariate associations between US damage score and mSASSS were found overall and in males, but diminished with older age. The association remained significant for males when the multivariable model was adjusted for symptom duration (rate ratio (95%\u2009CI) for log-transformed mSASSS+1: 1.32 (1.04 to 1.67)). Overall, mSASSS was not associated with the US damage score when the multivariable model was adjusted for age or symptom duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Structural lesions at the peripheral entheses are common in long-standing r-axSpA and accumulate with age, which may obscure the possible association with spinal bone formation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-006388","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T14:05:15Z","timestamp":1772633115000},"page":"e006388","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Relationship between ultrasound damage score of peripheral entheses and spinal bone formation in long-standing radiographic axial 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Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4430-0228","authenticated-orcid":false,"given":"Magnus","family":"Hallstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Department of Rheumatology, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lennart T H","family":"Jacobsson","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7871-5303","authenticated-orcid":false,"given":"Helena","family":"Forsblad-d\u2019Elia","sequence":"additional","affiliation":[{"name":"Department 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