الفهرس 
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Abstract
Psoriasis is a multisystemic, chronic inflammatory skin condition, with a strong genetic predisposition and autoimmune pathogenesis. PsA is an inflammatory arthropathy associated with psoriasis belonging to the group of spondyloarthritis (SpA), which show great varability in clinical features and severity.Ultrasound in PsA has been widely used in both clinical evaluation and research. It provides a potential window of opportunity which allows early diagnosis and predicting development of PsA, when identifying psoriatic patients with subclinical inflammatory features including enthesitis. Unlike clinical examination, US has been proved to provide a highly sensitive, fast, relatively cheap and non-invasive imaging tool of enthesitis, which is believed to be the primary lesion in SpA, including PsA.However there is still heterogeneity in the sonographic features in the existing ultrasound scores. So, additional adjustments are needed to standardize the US definition of enthesitis and distinguish active inflammatory changes from non-inflammatory conditions. The Aim of this study : Is to assess the role of ultrasound as a tool in diagnosis of enthesitis in psoriasis and psoriatic arthritis patients and comparing entheseal abnormalities between both types of patients. Materials and methods: The study included a total number of 50 patients, with 25 patients suffering of psoriatic arthritis (PsA), 25 patients with cutaneous psoriasis (PsC). Adult patients with PsA who satisfied the Classification of Psoriatic Arthritis (CASPAR) criteria were recruited from the Mansoura University Hospital, both rheumatology and dermatology outpatient`s clinic. Patients with PsC were recruited from Mansoura University Hospital, dermatology outpatient`s clinic. The patients were subjected to the following:Full medical history and clinical examination including peripheral entheses examination.Laboratory investigations:- Erythrocyte sedimentation rate, C- Reactive Protein, Rheumatoid Factor.Radiography : Plain X ray spine and sacroiliac joints.-US assessment of enthesitis using MASEI Scoring System Results: The studied 25 PsA patients, their mean age was 40. In addition to 25 PsC patients, their mean age was 36.6 years. No significant differences were found between both groups regarding age, gender and BMI. Duration of psoriasis in PsA group ranged from 6 to 18 years, while in PsC ranged from 1 to 20 years. Duration of arthritis ranged from 1 to 11 years. Conclusion: US is more accurate tool than clinical assessment alone in detecting enthesitis in PsA patients and in PsC patients as well. The severity of US entheseal abnormalities is higher in patients with PsA followed by PsC. MASEI score showed a positive correlation with different disease activity measures in both PsA and PsC patients.Incresed tendon thickness is the most frequent US abnormality finding was noticed in our study in both PsA and PsC patients.