Rheumatology · 3 h ago
DUET ultrasound score shows modest sensitivity for early psoriatic arthritis
A prospective, multicenter study developed and externally validated an ultrasound score to help distinguish early psoriatic arthritis (PsA) from non-inflammatory musculoskeletal symptoms. The score had 47–52% sensitivity and 73–100% specificity across cohorts; sensitivity was higher in patients with tender entheses.
- DUET assesses three entheseal sites using weighted ultrasound findings.
- Discovery cohort AUC was 0.65.
- External validation sensitivity was 49–52%.
- Sensitivity reached 63% with tender entheses.
Researchers prospectively enrolled patients with early PsA, psoriasis without arthritis, and controls with non-inflammatory musculoskeletal symptoms at 17 centers. In the discovery cohort, 213 participants had PsA, 100 had psoriasis without arthritis, and 106 were controls. Readers blinded to diagnosis assessed ultrasound images from 16 entheseal sites. The team used age-stratified models to select lesions and sites for the Diagnostic Ultrasound Enthesitis Tool (DUET), then assessed it in an external cohort of 101 patients with PsA and 69 controls.
DUET combines weighted inflammatory and structural ultrasound findings at the Achilles, proximal patellar tendon, and triceps insertions. In the discovery cohort, its area under the curve was 0.65, with 47–49% sensitivity and 73–74% specificity. In external validation, specificity ranged from 74% to 100%, while sensitivity was 49–52%. Sensitivity reached 63% among patients with tender entheses.
The externally validated score may support diagnostic assessment, particularly when entheses are tender, but its modest sensitivity means a negative score cannot reliably exclude PsA. The findings support use as an adjunct rather than a standalone diagnostic test; the supplied abstract does not report further implementation or clinical-outcome data.
In practice
For patients undergoing assessment for early psoriatic arthritis, DUET may provide supportive ultrasound evidence, especially when entheses are tender. It combines inflammatory and structural findings at three sites and was externally validated, but sensitivity was only 49–52% overall (up to 63% with tender entheses), so a negative result cannot exclude PsA. The reported discrimination was modest in the discovery cohort (AUC 0.65); the score should be considered an adjunct, not a standalone diagnostic test.
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Arthritis & Rheumatology: The development and validation of a new diagnostic sonographic enthesitis score for psoriatic arthritis: Diagnostic Ultrasound Enthesitis Tool ( DUET ) ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.