Observational studyRMD open2025
DEUS Enthesitis Index (DEI): a new tool integrating ultrasound and clinical examination for enthesitis assessment in spondyloarthritis.
Observational study in RMD open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- The Role of Musculoskeletal Ultrasound in Psoriatic Arthritis: From Preclinical Detection to Treatment Monitoring.Current rheumatology reports · 2026Review
- Temporal Clinical Ultrasound Asynchrony in Psoriatic Arthritis Enthesitis: Implications for Personalized Monitoring.Journal of personalized medicine · 2026Article
- Year in Review: Axial Spondyloarthritis.Mediterranean journal of rheumatology · 2026Review
- Biomarkers in axial spondyloarthritis diagnosis: from clinical signs to multi-omics integration.Frontiers in immunology · 2026Review
- Spondyloarthritis in Latin America: a difficult-to-diagnose challenge.Therapeutic advances in musculoskeletal disease · 2026Review
- Imaging pathways in spondyloarthritis: integrating radiography, ultrasonography, magnetic resonance imaging, low-dose computed tomography, and artificial intelligence methods : Radiology and AI in SpA.Rheumatology international · 2025Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectives(1) To develop a composite score, the DEUS (Defining Enthesitis on Ultrasound in Spondyloarthritis) Enthesitis Index (DEI), which integrates ultrasound and clinical examination findings for enthesitis assessment in patients with spondyloarthritis (SpA); (2) to examine the relationships between DEI and clinical features in this population, compared to the clinical examination of the entheses alone.
methodsThis was a cross-sectional, observational, multicentric study involving 20 rheumatology centres across 11 countries. Ultrasound and clinical examinations were performed bilaterally on the lower limb large entheses (ie, quadriceps tendon, proximal and distal patellar tendons, Achilles tendon and plantar fascia) in 413 patients with SpA, including 224 patients with axial SpA and 189 patients with psoriatic arthritis (PsA). A score of 1.0 for clinical enthesitis and 1.0 for ultrasound enthesitis was assigned for each of the 10 entheses evaluated. The total DEI score, which combines clinical and ultrasound findings, ranged from 0 to 20 per patient. Logistic and gamma regression models based on DEI were compared with those derived solely from clinical enthesitis assessment to evaluate their relative performance in explaining disease-related outcomes.
resultsAmong patients with SpA, the median DEI was 1.0 (IQR 0.0-3.0). DEI showed significant associations with SpA disease activity and severity indices in regression analyses, except for the Disease Activity in Psoriatic Arthritis score in patients with PsA. Compared with the clinical examination alone of the same entheses, DEI models exhibited a significantly better fit with C-reactive protein levels and ultrasound-detected structural damage at the enthesis (ie, enthesophytes and bone erosions). By contrast, the clinical examination alone models showed a significantly stronger fit with SpA disease activity indices and patient-reported outcomes compared with the DEI.
conclusionsDEI is a novel tool that integrates both ultrasound and clinical examination findings for enthesitis assessment, potentially ensuring a more reliable evaluation of this key domain in SpA.
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