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Ultrasound definition of enthesitis in spondyloarthritis and psoriatic arthritis: arrival or starting point?
  1. Emilio Filippucci,
  2. Gianluca Smerilli,
  3. Andrea Di Matteo,
  4. Walter Grassi
  1. Rheumatology Unit, Department of Clinical and Molecular Sciences, "Carlo Urbani" Hospital, Polytechnic University of Marche, Jesi, Italy
  1. Correspondence to Dr Emilio Filippucci, Rheumatology Unit, Polytechnic University of Marche - Department of Clinical and Molecular Sciences, "Carlo Urbani" Hospital, 60035 Jesi, Ancona, Italy; emilio_filippucci{at}


Enthesitis has a key role in the diagnosis, classification and management of patients with spondyloarthritis and psoriatic arthritis. Clinical assessment of enthesitis is known to be inaccurate mainly due to its poor specificity. In this context, ultrasound has the potential to improve the evaluation of enthesitis and, therefore, the management of patients with spondyloarthritis and psoriatic arthritis. In this viewpoint, we review the Outcome Measures in Rheumatology (OMERACT) definitions for ultrasound enthesitis, highlighting their current limits and potential implications on rheumatology research and clinical practice.

  • ultrasonography
  • arthritis
  • psoriatic
  • tendinopathy

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  • Handling editor Josef S Smolen

  • Contributors All authors contributed to this viewpoint conception and design. Images preparation was performed by EF, GS and ADM. The first draft of the manuscript was written by EF and all the authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests EF has received speaking fees from AbbVie, Amgen, BMS, Janssen, Lilly, Novartis, Roche, Pfizer and UCB Pharma. WG has received speaking fees from Celltrion and Pfizer. All other authors declare no competing interests.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.