Thickened Pulleys in PsA Support Deep Koebnerization in Dactylitis rheumatologyadvisor.com Deep Dive Into the Causes of Dactylitis Researchers look deep to find the cause of synovitis and dactylitis in patients with psoriatic arthritis. rheumatologynetwork.com ‘Deep Koebner’ phenomenon of the flexor tendon-associated accessory pulleys as a novel factor in tenosynovitis and dactylitis in psoriatic arthritis ard.bmj.co