Achilles tendinitis in psoriasis: clinical and sonographic findings

J Am Acad Dermatol. 2003 Aug;49(2):217-22. doi: 10.1067/s0190-9622(03)00904-6.


Background: Involvement of the Achilles tendon is frequent in psoriatic arthritis, but it is easily missed at clinical examination.

Objective: To seek evidence of Achilles tendon abnormalities by means of sonography in psoriatic patients and to correlate sonographic findings with clinical symptoms (tendon and soft-tissue swelling, pain, and difficulty in walking).

Methods: Fifty-nine patients with plaque-type psoriasis (Psoriasis Area and Severity Index score, 3.7-34.7) and 50 healthy, aged-matched volunteers underwent clinical and sonographic evaluation of Achilles tendons and peritendinous structures.

Results: Eighteen (30.5%) of the 59 patients had clinical symptoms of Achilles tendinitis. Thirty-five (59.3%) of the patients had sonographic abnormalities. Of these, 13 patients had clinically symptomatic abnormalities, and 11 had psoriatic arthritis. Degenerative tendinitis was the most frequent sonographic finding (76.9%) among patients with symptomatic conditions. Five patients with symptoms did not have sonographic alterations. None of the controls had clinical or sonographic changes.

Conclusions: In psoriatic patients Achilles tendon abnormalities cannot be excluded even when they are clinically absent.

MeSH terms

  • Achilles Tendon / anatomy & histology
  • Achilles Tendon / diagnostic imaging*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthritis, Psoriatic / diagnosis
  • Arthritis, Psoriatic / diagnostic imaging*
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Tendinopathy / diagnosis
  • Tendinopathy / diagnostic imaging*
  • Ultrasonography