الفهرس 
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Abstract
Psoriasis is an inflammatory skin disease characterized by itchy, erythematous, scaly lesions, papules and sometimes pustules (Boehncke and Schön, 2015).
About 11% of those diagnosed with psoriasis have also been diagnosed with psoriatic arthropathy (PsA). However, about 30% of people with psoriasis will eventually develop PsA. While joint affection is the main distinguishing feature between PsA and psoriasis, a well known extra-articular feature of PsA is tendinopathy and enthesopathy (Ritchlin et al., 2017).
PsA shows significant clinical variability with potential involvement of both the peripheral and the axial skeleton. In addition to arthritis, inflammatory changes include other tissues resulting in enthesitis and dactylitis which are the hallmarks of PsA (Coates et al., 2012).
MSUS is a rapidly evolving technique that helps determining the joint structure involved in the inflammatory process and is one of the radiological methods recommended to reveal synovitis at any joint and has the potential to be used not only to detect joint synovitis, but also to examine the surrounding soft tissues in order to determine the presence of tenosynovitis, dactylitis and/or enthesitis (Ruta and Alva, 2016).
MSUS has been known to be a reliable tool in detecting enthesitis and is more accurate than clinical examination, conventional radiography, and even MRI, especially during the early stages of inflammatory process in enthesitis (Ozçakar et al., 2005).
Furthermore, occult enthesitis detected using MSUS, especially with a power Doppler signal, has a predictive value for the occurance of joint changes in patients with psoriasis (El Miedany et al., 2015).
Psoriatic patients without joint involvement of young and middle aged groups are more susceptible for synovitis, enthisitis and tenosynovitis which may detect occult joint involvement predicting the clinical onset of PsA in these age groups therefore regular US examination is of benefit to patients with PsA, and more attention should be paid to young and middle aged non-PsA psoriatic patients (Tang et al., 2018).