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Sudoł-Szopińska I, Kwiatkowska B, Prochorec-Sobieszek M, et al. Enthesopathies and enthesitis. Part 2: Imaging studies. J Ultrason. 2015;15(61):196-207doi: 10.15557/JoU.2015.0017.
Sudoł-Szopińska, I., Kwiatkowska, B., Prochorec-Sobieszek, M., Pracoń, G., Walentowska-Janowicz, M., & Maśliński, W. (2015). Enthesopathies and enthesitis. Part 2: Imaging studies. Journal of ultrasonography, 15(61), 196-207. https://doi.org/10.15557/JoU.2015.0017
Sudoł-Szopińska, Iwona, et al. "Enthesopathies and enthesitis. Part 2: Imaging studies." Journal of ultrasonography vol. 15,61 (2015): 196-207. doi: https://doi.org/10.15557/JoU.2015.0017
Sudoł-Szopińska I, Kwiatkowska B, Prochorec-Sobieszek M, Pracoń G, Walentowska-Janowicz M, Maśliński W. Enthesopathies and enthesitis. Part 2: Imaging studies. J Ultrason. 2015 Jun;15(61):196-207. doi: 10.15557/JoU.2015.0017. Epub 2015 Jun 30. PMID: 26672488; PMCID: PMC4579753.
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J Ultrason. 2015 Jun;15(61):196-207. doi: 10.15557/JoU.2015.0017. Epub 2015 Jun 30.

Enthesopathies and enthesitis. Part 2: Imaging studies.

Journal of ultrasonography

Iwona Sudoł-Szopińska, Brygida Kwiatkowska, Monika Prochorec-Sobieszek, Grzegorz Pracoń, Marta Walentowska-Janowicz, Włodzimierz Maśliński

Affiliations

  1. Department of Radiology, Institute of Rheumatology, Warsaw, Poland ; Department of Diagnostic Imaging, Second Faculty, Warsaw Medical University, Poland.
  2. Early Arthritis Clinic, Institute of Rheumatology, Warsaw, Poland.
  3. Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland ; Department of Pathophysiology, Immunology, and Pathological Anatomy, Institute of Rheumatology, Warsaw, Poland.
  4. Department of Radiology, Institute of Rheumatology, Warsaw, Poland.
  5. Department of Pathophysiology, Immunology, and Pathological Anatomy, Institute of Rheumatology, Warsaw, Poland.

PMID: 26672488 PMCID: PMC4579753 DOI: 10.15557/JoU.2015.0017

Abstract

The pathologies of tendon and ligament attachments are called enthesopathies. Enthesitis is one of enthesopathies and it is considered a characteristic sign of rheumatic diseases from the spondyloarthritis group, including peripheral spondyloarthritis. Therefore, enthesitis has been included in a number of clinical classifications for diagnosing these diseases. Clinical diagnosis of enthesitis is based on rather non-specific clinical signs and results of laboratory tests. It is believed that imaging examinations might improve diagnosis, particularly because numerous papers prove that differentiating enthesitis from other enthesopathic processes is possible. On the other hand, a number of authors report the lack of specific signs in imaging as well as typical histological and immunological features that would enable confirmation of clinical diagnosis of enthesitis. The first part of the publication presented theories on the etiopathogenesis of enthesitis (inflammatory, mechanical, autoimmune and associated with the synovio-entheseal complex) as well as on the formation of enthesophytes (inflammatory, molecular and mechanical). This paper - the second part of the article, is a review of the state-of-the-art on the ability of imaging examinations to diagnose enthesitis. It turns out that none of the enthesitis criteria used in imaging examinations is specific for inflammation. As enthesitis may be the only symptom of early spondyloarthritis (particularly in patients with absent HLA-B27 antigen), the lack of its unambiguous picture in ultrasound and magnetic resonance imaging prompts the search for other signs characteristic of spondyloarthritis and more specific features in imaging in order to make a diagnosis as early as possible.

Keywords: enthesitis; enthesopathy; imaging; rheumatic diseases; spondyloarthritis

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