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Ultrasonography in psoriatic arthritis: which sites should we scan?
  1. Alen Zabotti1,
  2. Matteo Piga2,
  3. Marco Canzoni3,
  4. Garifallia Sakellariou4,
  5. Annamaria Iagnocco5,
  6. Carlo Alberto Scirè6,7
  7. on behalf of the UPSTREAM study group.
    1. 1Department of Medical and Biological Sciences, Rheumatology Clinic, University Hospital ‘Santa Maria della Misericordia’, Udine, Italy
    2. 2Chair of Rheumatology and Rheumatology Unit, University Clinic and AOU of Cagliari, Cagliari, Italy
    3. 3Local Health Unit (ASL) Rome-1, Rome-4, Viterbo, Italy
    4. 4Division of Rheumatology, IRCSS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
    5. 5Department of Medical and Biological Sciences, University of Turin, Torino, Italy
    6. 6Department of Medical Sciences, Section of Rheumatology, University of Ferrara, Ferrara, Italy
    7. 7Epidemiology Unit, Italian Society of Rheumatology (SIR), Milan, Italy
    1. Correspondence to Dr Alen Zabotti, Department of Medical and Biological Sciences, University Hospital, ‘Santa Maria della Misericordia’, Udine 33100, Italy; zabottialen{at}

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    In psoriatic arthritis (PsA), ultrasonography (US) plays a growing role in the differential diagnosis and in monitoring treatment response.1 PsA is a heterogeneous disease with different domains and peculiar sites involved.2 Therefore, a dedicated US composite score is needed to monitor disease activity and to identify structural damage progression. A recently published Systematic Literature Review (SLR) identified only two US scores specifically developed for PsA (ie, 5TPD and PsA-Son) and, although these had a good sensitivity to detect inflammation and a good feasibility, they have not been validated in other series.1 3 4 Recently, the Study Group for US of the Italian Society of Rheumatology promoted the Ultrasound in PSoriatic Arthritis TREAtMent (UPSTREAM) study (registered at, NCT03330769). UPSTREAM is a multicentre observational prospective cohort study and it represents the first …

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