{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T02:43:07Z","timestamp":1785552187796,"version":"3.56.0"},"reference-count":24,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T00:00:00Z","timestamp":1640736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>In psoriatic arthritis (PsA) patients with concomitant chronic widespread pain, the differential diagnosis with fibromyalgia syndrome (FMS) can be challenging. We evaluated whether ultrasound (US) examination of entheseal sites can distinguish pain from (PsA) enthesitis versus FMS. PsA and FMS patients underwent clinical evaluation and gray-scale (GS; B-mode) and power Doppler (PD) US examination of the entheses. At least one enthesis with GS- and PD-mode changes was found in 90% and 59.3% of PsA patients (n = 140) and 62.7% and 35.3% of FMS patients (n = 51), respectively. GS and PD identified changes in 49.5% and 19.2% of the 840 PsA entheses and 22.5% and 7.9% of the 306 FMS entheses, respectively. Receiver operating characteristic curve analysis showed an area under the curve of 0.77 and 0.66 for B- and PD-mode, respectively, 3.5 being the best cut-off GS-score to discriminate the two conditions. Multivariate regression showed that Achilles and proximal patellar tendon enthesitis (B-mode) were strongly associated with PsA (odds ratio, ~2). Principal component analysis (B-mode) confirmed that PsA patients have a higher number of involved entheses and patterns of entheseal involvement than FMS patients. US evaluation of the entheses may help differentiate chronic widespread pain from PsA versus FMS.<\/jats:p>","DOI":"10.3390\/jcm11010180","type":"journal-article","created":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T23:31:35Z","timestamp":1640820695000},"page":"180","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Use of Ultrasonography to Discriminate Psoriatic Arthritis from Fibromyalgia: A Post-Hoc Analysis of the ULISSE Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0714-5902","authenticated-orcid":false,"given":"Antonio","family":"Marchesoni","sequence":"first","affiliation":[{"name":"Rheumatology, Humanitas San Pio X, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Macchioni","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia and Universit\u00e0 di Modena and Reggio Emilia, 42123 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Gasparini","sequence":"additional","affiliation":[{"name":"Reumatologia, Dipartimento di Medicina Interna, Ospedale di Fabriano, ASUR Marche, 62012 Fabriano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4771-6981","authenticated-orcid":false,"given":"Carlo","family":"Perricone","sequence":"additional","affiliation":[{"name":"Rheumatology, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3771-5205","authenticated-orcid":false,"given":"Fabio Massimo","family":"Perrotta","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina e Scienze della Salute \u201cVincenzo Tiberio\u201d, Universit\u00e0 degli Studi del Molise, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Daniela","family":"Grembiale","sequence":"additional","affiliation":[{"name":"Rheumatology Research Unit, Department of Health Sciences, \u201cMagna Graecia\u201d University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7654-8222","authenticated-orcid":false,"given":"Ettore","family":"Silvagni","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliero-Universitaria S. Anna, 44122 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9683-8873","authenticated-orcid":false,"given":"Roberta","family":"Ramonda","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medicine-DIMED, University of Padova, 35131 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Costa","sequence":"additional","affiliation":[{"name":"Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80125 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0573-464X","authenticated-orcid":false,"given":"Alen","family":"Zabotti","sequence":"additional","affiliation":[{"name":"Department of Medical and Biological Science, Rheumatology Clinic, University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Curradi","sequence":"additional","affiliation":[{"name":"AbbVie Srl, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliana","family":"Gualberti","sequence":"additional","affiliation":[{"name":"AbbVie Srl, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Marando","sequence":"additional","affiliation":[{"name":"AbbVie Srl, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Salvarani","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia and Universit\u00e0 di Modena and Reggio Emilia, 42123 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1002\/acr.20140","article-title":"The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity","volume":"62","author":"Wolfe","year":"2010","journal-title":"Arthritis Care Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.semarthrit.2016.08.012","article-title":"2016 Revisions to the 2010\/2011 Fibromyalgia Diagnostic Criteria","volume":"46","author":"Wolfe","year":"2016","journal-title":"Semin. 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