The Achilles tendon (AT) insertion is the most common site of enthesitis in psoriatic arthritis (PsA). A cross-sectional, observational study compared AT structure and function among patients with PsA and with and without AT pain and healthy controls using clinical and ultrasound (US) examinations, performance-based testing, and patient-reported outcomes. The study found that patients with PsA and AT pain had significantly worse Victorian Institute of Sport Assessment-Achilles scores and more prevalent inflammatory US features compared with those without AT pain and healthy controls. Clinical examination alone often missed cases of US-confirmed AT enthesitis. Both PsA groups had lower heel raise test repetition rates and walked slower than healthy controls.
This study showed that the prevalence of mid-portion AT pathology in PsA remains underexplored. US features revealed structural and inflammatory changes more common in patients with PsA, particularly those with AT pain. Despite management per current guidelines, AT pain persisted, causing severe functional impairment. The study underscores the need for improved assessment and targeted management strategies for AT pathology in PsA.
Reference: Patience A, Steultjens M, Siebert S, Hendry G. Significant functional impairment and disability in individuals with psoriatic arthritis and Achilles tendon pain: a cross-sectional observational study. Rheumatol Int. 2024;44(8):1469-1479. doi: 10.1007/s00296-024-05629-x.
Link: https://link.springer.com/article/10.1007/s00296-024-05629-x
