Clinical and ultrasonography assessment of peripheral enthesitis in ankylosing spondylitis

Spadaro, Antonio; Iagnocco, Annamaria; Perrotta, Fabio Massimo; Modesti, M; Scarno, Antongiulio; Valesini, Guido

doi:10.1093/rheumatology/ker284

Cited by 75 publications

(56 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hamdi et al 99 reported correlation with clinical enthesis indices (Maastricht Ankylosing Spondylitis Score, Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Index), while two studies reported no correlation 39 98. Two studies reported discrepancies in abnormal entheses detected by US versus clinical examination 40 105…”

Section: Resultsmentioning

confidence: 99%

EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice

et al. 2015

View full text Add to dashboard Cite

A taskforce comprised of an expert group of 21 rheumatologists, radiologists and methodologists from 11 countries developed evidence-based recommendations on the use of imaging in the clinical management of both axial and peripheral spondyloarthritis (SpA). Twelve key questions on the role of imaging in SpA were generated using a process of discussion and consensus. Imaging modalities included conventional radiography, ultrasound, magnetic resonance imaging, computed tomography (CT), positron emission tomography, single photon emission CT, dual-emission x-ray absorptiometry and scintigraphy. Experts applied research evidence obtained from systematic literature reviews using MEDLINE and EMBASE to develop a set of 10 recommendations. The strength of recommendations (SOR) was assessed by taskforce members using a visual analogue scale. A total of 7550 references were identified in the search process, from which 158 studies were included in the systematic review. Ten recommendations were produced using research-based evidence and expert opinion encompassing the role of imaging in making a diagnosis of axial SpA or peripheral SpA, monitoring inflammation and damage, predicting outcome, response to treatment, and detecting spinal fractures and osteoporosis. The SOR for each recommendation was generally very high (range 8.9–9.5). These are the first recommendations which encompass the entire spectrum of SpA and evaluate the full role of all commonly used imaging modalities. We aimed to produce recommendations that are practical and valuable in daily practice for rheumatologists, radiologists and general practitioners.

show abstract

Section: Resultsmentioning

confidence: 99%

EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Several published studies have reported significantly higher enthesitis scores in the US assessed groups in comparison to the groups evaluated only by clinical examination. US assessment was made in grey scale alone or combined with Doppler mode, for lower and or upper limbs [3,6,[27][28][29][30][31]33,35,62,63,66,69,78] .…”

Section: Subclinical Enthesitismentioning

confidence: 99%

“…In the latter years, new imaging modalities such as magnetic resonance imaging (MRI) and ultrasound (US) have been developed, offering a direct visualization of the enthesis and enthesal-related structures. Subsequently, an earlier and a more accurate, inflammatory and structural lesion detection in symptomatic and asymptomatic entheseal areas is expected [3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Concepts in monitoring enthesitis in patients with spondylarthritis- the role of musculoskeletal ultrasound

Micu

Fodor

2016

Med Ultrason

View full text Add to dashboard Cite

Enthesitis is the key pathological lesion in the spondyloarthritides group and an important element for early diagnosis with a predictive and prognostic value. The recognition of enthesitis on a clinical basis alone remains a challenge and creates unnecessary delays in diagnosis and adequate treatment commencement. Musculoskeletal ultrasound is a valid, reliable, and feasible imaging tool valuable for identifying inflammatory and structural lesions at enthesis level, helpful in establishing a diagnosis, evaluating disease activity and therapy monitoring. This paper focuses on the most relevant aspects of current literature regarding enthesitis and highlights the musculoskeletal ultrasound added value in enthesis assessment.

show abstract

“…Among them is ankylosing spondylitis (AS), in which enthesitis of the heel is common and occasionally is responsible for their initial symptom to seek clinics [2]. Enthesitis is defined as inflammation at the bony interfaces of ligaments, tendons, aponeurosis, annulus fibrosus and joint capsules [3]. Because many of such structures originate from, are inserted in, and also pass alongside the calcaneus, heel pain is frequent peripheral symptom in AS patients from enthesitis of inferior and posterior calcaneus [1,4,5].…”

Section: Introductionmentioning

confidence: 99%

Does Painful Heels in Ankylosing Spondylitis Demonstrate Distinctive Features on Plain Radiographs: A Study of 104 Cases

et al. 2017

View full text Add to dashboard Cite

Objective. To investigate simple radiographic findings on painful heels in ankylosing spondylitis (AS). Heel radiography in most studies was from AS patients' non-painful heel. Methods. Seventy AS patients (34 bilateral cases) with heel pain at the time digital radiographs were taken were studied. Standing lateral views (104 radiographs) of the heel were reviewed. Associations between radiologic abnormalities and disease duration and among various abnormal findings were analyzed. Results. Ninety-six (93.4%) had radiographic abnormalities (82.7% in soft tissues/61.5% in bone). Abnormalities of bone only were observed in 9.6%, of the soft tissues only in 30.8%, and of both were 51.9%. These included Kager's triangle's blurring (77.9%), posterior soft tissue swellings near the Achilles tendon insertion (65.4%), obliterations of the retrocalcaneal recess (65.4%), erosions of the superior pole of the posterior calcaneus (31.7%), subplantar irregular spurs (20.2%), posterior traction spurs (16.3%), subplantar erosions (14.4%) and cortical thickenings of the inferior calcaneal body (5.8%). There was a significant association between swelling in the posterior soft tissue and obliteration of the retrocalcaneal recess (p＜0.001). Conclusion. Digital radiography in AS is useful for observing not only bony lesions but also soft tissue abnormalities of the heel, particularly of the posterior heel. For assessing the symptomatic enthesitis of the Achilles, this simple and quick diagnostic tool is valuable when examining for soft tissues' alterations of the posterior heel. (J Rheum Dis 2017;24:93-98)

show abstract

Clinical and ultrasonography assessment of peripheral enthesitis in ankylosing spondylitis

Abstract: PDUS permits detection of structural and inflammatory abnormalities of the enthesis in AS and may complement the physical examination in order to better evaluate enthesitis.

Cited by 75 publications

References 20 publications

EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice

EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice

Concepts in monitoring enthesitis in patients with spondylarthritis- the role of musculoskeletal ultrasound

Does Painful Heels in Ankylosing Spondylitis Demonstrate Distinctive Features on Plain Radiographs: A Study of 104 Cases

Contact Info

Product

Resources

About