Peritenon Extensor Tendon Inflammation Linked to Enthesitis in Psoriatic Arthritis

PsA of hand
PsA of hand
Researchers analyzed the association between enthesitis, synovitis, and peritenon extensor tendon inflammation in psoriatic arthritis.

Peritenon extensor tendon inflammation was found to be associated with enthesitis, but not metacarpophalangeal joint synovitis, in patients with psoriatic arthritis (PsA), according to study results published in The Journal of Rheumatology.

Researchers conducted an imaging study of 27 patients with PsA who were assessed for synovitis and peritenon extensor tendon inflammation using grey scale and power Doppler ultrasound. Study participants were assessed for enthesitis using the Madrid Sonographic Enthesis Index (MASEI). Prior to ultrasound imaging, patients received a clinical examination by a rheumatologist who was blinded to the subsequent ultrasound data.

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After examination, the researchers found no association between enthesitis and synovitis in study participants. Conversely, they observed an association between enthesitis and peritenon extensor tendon inflammation. In addition, peritenon extensor tendon inflammation measured with power Doppler and grey scale showed an association with power Doppler synovitis (P =.009 and P =.037), but synovitis measured with grey scale demonstrated no association with power Doppler or grey scale peritenon extensor tendon inflammation (P =.055 and P =.334, respectively).

Primary study limitations were the small sample size and the lack of clinical data related to enthesitis.

“The present study finds [peritenon extensor tendon inflammation] to be associated with active enthesitis as opposed to synovitis, which may support a functional association between [peritenon extensor tendon inflammation] and enthesitis,” the researchers wrote. “This possible association should be explored further in larger studies, as well at the implication of [peritenon extensor tendon inflammation] on PsA treatment.”


Macia-Villa C, Falcao S, Gutierrez M, Medina J, Hammer HB, De Miguel E. Peritenon extensor tendon inflammation in psoriatic arthritis is an enthesitis-related lesion [published online February 1, 2019]. J Rheumatol. doi:10.3899/jrheum.180856