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1. Methods

Consecutive PsA patients and rheumatoid arthritis (RA) controls were included in a multi-center prospective study. In each rheumatology unit, patients underwent clinical examination, laboratory tests and PDUS examination (Logiq9/Logiq5 GE machine; 8–15 MHz linear probe) of major entheses at both extremities. Previously to patients’ enrolment, the US examination methodology was clarified among sonographers and a consensus was obtained on scanning protocol and image interpretation. By using the OMERACT definition for enthesopathy [6], different elementary lesions were assessed by PDUS and scored either on a semi-quantitative (0–3) or a dichotomous (0–1) scale. The sums of the local scores at single entheseal sites and at a global entheseal level (global entheseal PDUS score) were calculated. The following entheses were examined bilaterally: common extensor tendon at its insertion at the lateral humeral epicondyle; gluteus tendons at their insertion at the greater trochanter; quadriceps tendon at its insertion at the superior pole of the patella; patellar tendon at its proximal insertion at the inferior pole of the patella; patellar tendon at its distal insertion at the tibia tuberosity; Achilles tendon at its insertion at the calcaneus; plantar aponeuroses at its insertion at the calcaneus.