Enthesis Assessment in Patients with Chronic Plaque Psoriasis by High-Resolution Ultrasonography: A Hospital-Based Cross-Sectional Study
Kallolinee Samal, Bikash Kar, Manoranjan Khuntia, Anisha Biswal, Adya Kinkar Panda, Nibedita DixitAbstract
Background:
Enthesitis, a hallmark of psoriatic arthritis (PsA), can also occur in psoriasis patients without clinical arthritis. This study assessed subclinical enthesitis in chronic plaque psoriasis using ultrasonography (USG) and the OMERACT scoring system.
Objective:
To evaluate subclinical enthesitis in psoriasis patients and its correlation with disease severity, duration, and clinicodemographic parameters.
Materials and Methods:
This prospective cross-sectional study included 91 chronic plaque psoriasis patients at a tertiary care hospital in East India (January 2024–January 2025). Patients with PsA or systemic conditions were excluded. Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index scores were recorded, and USG assessed 12 entheseal sites for inflammatory (hypoechogenicity, thickening, Doppler signal) and structural (calcifications, enthesophytes, erosions) changes. Statistical significance was set at
Results:
The study included 91 patients (mean age 42.8 ± 9.6 years, male-to-female ratio 2.1:1). Plaque psoriasis was the most common subtype (72%). Subclinical enthesitis was present in 85.7% of patients (78/91) with 929 USG-positive sites. Structural abnormalities were observed in 75% (69/91) and inflammatory changes in 72 patients (506 sites), most commonly in the Achilles tendon. Higher PASI scores correlated with entheseal abnormalities (
Conclusion:
Subclinical enthesopathy is highly prevalent in psoriasis patients. USG using the OMERACT scoring system is valuable for early detection, supporting routine musculoskeletal screening to prevent PsA progression.