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Enthesitis ultrasound

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https://www.readbyqxmd.com/read/30323008/development-of-a-preliminary-ultrasonographic-enthesitis-score-in-psoriatic-arthritis-grappa-ultrasound-working-group
#1
Stephanie Tom, Yujie Zhong, Richard Cook, Sibel Zehra Aydin, Gurjit Kaeley, Lihi Eder
OBJECTIVE: To assess the performance of various sonographic elemental entheseal lesions in distinguishing between psoriatic arthritis (PsA) and controls to inform the development of a novel sonographic enthesitis score for PsA. METHODS: A total of 100 age- and sex-matched individuals (50 PsA and 50 controls) were evaluated. Eleven entheseal sites were scanned bilaterally according to a standardized protocol by 2 sonographers. Based on the Outcome Measures in Rheumatology (OMERACT) definition of sonographic enthesitis, the following lesions were assessed: structural entheseal changes (hypoechogenicity), thickening, bone erosion, enthesophytes, calcification, and Doppler signal, in addition to bursitis and bone irregularities...
October 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/30302556/is-ultrasonographic-enthesitis-evaluation-helpful-for-diagnosis-of-non-radiographic-axial-spondyloarthritis
#2
Tugba Ozsoy-Unubol, Ilker Yagci
The aim of this study is to evaluate the diagnostic utility of ultrasonographic enthesitis assessment in patients with non-radiographic axial spondyloarthritis (nr-axSpA) and to compare different sonographic scoring methods. Patients with nr-axSpA (n = 30) and mechanical back pain (MBP) (n = 30) were enrolled in the study with standardized clinical criteria. For both of the groups, a total of 18 entheses were evaluated in each patient with B mode ultrasound and power Doppler by a sonographer who is blinded to initial clinical and radiological assessments...
October 9, 2018: Rheumatology International
https://www.readbyqxmd.com/read/30296977/enthesitis-detection-by-ultrasound-where-are-we-now
#3
REVIEW
Maria-Antonietta D'Agostino
Over the last 25 years, ultrasound has been used to evaluate involvement at the entheses in spondyloarthritis (SpA) and psoriatic arthritis (PsA). Several studies have been reported indicating its value in detecting active inflammation at entheseal sites using both gray scale and Doppler findings. This review explores the recent literature and appraises the current knowledge and the unmet needs of enthesitis detection by ultrasound in the management of both SpA and PsA.
September 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/30260423/greater-magnitude-of-entheseal-microdamage-and-repair-in-psoriatic-arthritis-compared-with-ankylosing-spondylitis-on-ultrasound
#4
Fatima Arslan Alhussain, Esen Kasapoglu Gunal, Esra Kurum, Sibel Bakirci, Ayse Bilge Ozturk, Dennis McGonagle, Sibel Zehra Aydin
Objectives: AS and PsA share clinical and immunological features centred on enthesitis. However, a strong association between PsA and preceding injury has been recognized. The aim of this study was to test the hypothesis that the entheseal damage seen by US is commoner in PsA patients than in AS patients. Methods: Seventy-nine AS and 85 PsA patients had US scans of 1640 entheses to calculate entheseal inflammation (hypoechogenicity, thickening and Doppler) and damage scores (calcifications, enthesophytes and erosions)...
September 26, 2018: Rheumatology
https://www.readbyqxmd.com/read/30183592/clinical-implications-of-peripheral-new-bone-formation-in-psoriatic-arthritis-a-literature-based-review
#5
REVIEW
Antonio Marchesoni, Roberto Caporali, Ennio Lubrano
While the destructive changes of peripheral articular damage of psoriatic arthritis (PsA) are extensively studied, the productive modifications have been somewhat neglected. This literature-based study focuses on the clinically relevant aspects of peripheral bone proliferation in PsA. New bone proliferation frequently occurs as juxta-articular and entheseal apposition in PsA patients but also in psoriatic patients without arthritis, the Psoriatic Arthritis Ratingen Score is the only radiographic method to evaluate peri-articular new bone formation, numerous ultrasound systems to score entheseal changes have been proposed, several serum biomarkers of bone-turnover have been associated with PsA and psoriasis but they do not have clinical relevance...
August 29, 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/30167592/what-s-new-in-musculoskeletal-ultrasound-in-pediatric-rheumatology
#6
REVIEW
Mihaela Spârchez, Daniela Fodor
Musculoskeletal ultrasound (MSUS) has become almost indispensable in the rheumatology settings nowadays, allowing early diagnosis, careful guidance during procedures such as joint injections and therapy monitoring. Nonetheless, the applicability of MSUS in pediatric population is still limited. Recently, a standardized MSUS examination procedure in pediatric patients with rheumatic diseases, definitions for synovitis and the sonographic features of joints in healthy children has been developed. Also, important data on age-related  vascularization and ossification of joints in children have been published...
August 30, 2018: Medical Ultrasonography
https://www.readbyqxmd.com/read/30167327/can-power-doppler-ultrasound-of-the-entheses-help-in-classifying-recent-axial-spondyloarthritis-data-from-the-desir-cohort
#7
Cecile Poulain, Maria Antonietta D'Agostino, Severine Thibault, Jean Pierre Daures, Salah Ferkal, Philippe Le Corvoisier, Alain Rahmouni, Damien Loeuille, Maxime Dougados, Pascal Claudepierre
Early diagnosis of axial spondyloarthritis (axSpA) remains a challenge due to the lack of specificity of clinical symptoms and variable prevalence of axial imaging findings permitting a definite diagnosis. Power Doppler ultrasonography (PDUS) of the entheses has demonstrated to be a potential useful tool for the classification and diagnostic management of early SpA independently of the phenotype. Objectives: To assess the classification value (sensitivity and specificity) of PDUS-defined enthesitis for identifying patients fulfilling Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axSpA (ASAS+) in patients with recent inflammatory back pain (IBP) (the DESIR (DEvenir des Spondylarthropathies Indifférenciées Récentes) cohort)...
2018: RMD Open
https://www.readbyqxmd.com/read/30117018/enthesitis-and-dactylitis-in-psoriatic-disease-a-guide-for-dermatologists
#8
REVIEW
Jerry Bagel, Sergio Schwartzman
Psoriatic arthritis (PsA) is an inflammatory arthritis that is estimated to affect approximately 30% of patients with psoriasis. Enthesitis and dactylitis, two hallmarks of PsA, are associated with radiographic peripheral/axial joint damage and severe disease. Clinical symptoms of enthesitis include tenderness, soreness, and pain at entheses on palpation, whereas dactylitis is recognized by swelling of an entire digit that is different from adjacent digits. Both ultrasound and magnetic resonance imaging can be used to diagnose enthesitis and dactylitis, especially in patients in whom symptoms may be difficult to discern...
August 16, 2018: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/30076154/reliability-of-a-consensus-based-ultrasound-definition-and-scoring-for-enthesitis-in-spondyloarthritis-and-psoriatic-arthritis-an-omeract-us-initiative
#9
Peter V Balint, Lene Terslev, Philippe Aegerter, George Arthur Willem Bruyn, Isabelle Chary-Valckenaere, Frederique Gandjbakhch, Annamaria Iagnocco, Sandrine Jousse-Joulin, Ingrid Möller, Esperanza Naredo, Wolfgang A Schmidt, Richard J Wakefield, Maria-Antonietta D'Agostino
OBJECTIVES: To evaluate the reliability of consensus-based ultrasound (US) definitions of elementary components of enthesitis in spondyloarthritis (SpA) and psoriatic arthritis (PsA) and to evaluate which of them had the highest contribution to defining and scoring enthesitis. METHODS: Eleven sonographers evaluated 40 entheses from five patients with SpA/PsA at four bilateral sites. Nine US elementary lesions were binary-scored: hypoechogenicity, thickened insertion, enthesophytes, calcifications, erosions, bone irregularities, bursitis and Doppler signal inside and around enthesis...
August 3, 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/30008458/psoriatic-arthritis-sonographic-enthesitis-instruments-a-systematic-review-of-the-literature
#10
Ofir Elalouf, Sibel Bakirci Ureyen, Zahi Touma, Melanie Anderson, Gurjit S Kaeley, Sibel Z Aydin, Lihi Eder
OBJECTIVE: As part of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) ultrasound working group, we performed a systematic review of the literature to assess the evidence and knowledge gaps in scoring instruments of enthesitis in psoriatic arthritis (PsA). METHODS: A systematic search of PubMed, EMBase, and Cochrane databases was performed. The search strategy was constructed to find original publications containing terms related to ultrasound, enthesitis, spondyloarthritis (SpA) or PsA...
July 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29991631/clinical-and-ultrasonographic-predictors-for-achieving-minimal-disease-activity-in-patients-with-psoriatic-arthritis-the-upstream-ultrasound-in-psoriatic-arthritis-treatment-prospective-observational-study-protocol
#11
Marco Canzoni, Matteo Piga, Alen Zabotti, Carlo Alberto Scirè, Greta Carrara, Ignazio Olivieri, Annamaria Iagnocco
INTRODUCTION: Psoriatic arthritis (PsA) occurs in 10%-15% of people with psoriasis and accounts for 10%-20% of early arthritis clinics referral. Only a few prognostic factors of therapeutic response in patients with PsA have been identified. In the last years, the role of imaging has grown up and the European League Against Rheumatism recognised that ultrasound (US) has higher sensitivity than clinical examination to detect inflammatory disease activity. The aims of the Ultrasound in PSoriatic arthritis TREAtMent (UPSTREAM) study are to integrate clinic and US in order to inform whether US has provide an added prognostic value in PsA...
July 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29982722/entheseal-involvement-in-patients-with-systemic-lupus-erythematosus-an-ultrasound-study
#12
Andrea Di Matteo, Emilio Filippucci, Edoardo Cipolletta, Iulia Satulu, Jana Hurnakova, Valentina Lato, Rossella De Angelis, Rudolf Horvath, Karel Pavelka, Fausto Salaffi, Walter Grassi
Objectives: The main objective of this study is to explore the prevalence and distribution of entheseal US changes in a cohort of SLE patients, taking as controls a group including both PsA patients and healthy subjects. The secondary objective is to investigate the correlation between the US findings and the clinical and serological data in SLE patients. Methods: Clinical and US assessment of quadriceps, patellar and Achilles tendons, and plantar fascia entheses were performed by independent rheumatologists on 65 patients with SLE, 50 patients with PsA and 50 healthy subjects...
October 1, 2018: Rheumatology
https://www.readbyqxmd.com/read/29975012/pain-mechanisms-and-ultrasonic-inflammatory-activity-as-prognostic-factors-in-patients-with-psoriatic-arthritis-a-prospective-cohort-study
#13
Pil Højgaard, Karen Ellegaard, Sabrina Mai Nielsen, Robin Christensen, Jørgen Guldberg-Møller, Christine Ballegaard, Lene Dreyer, Philip Mease, Maarten de Wit, Lone Skov, Bente Glintborg, Henning Bliddal, Else Marie Bartels, Kirstine Amris, Lars Erik Kristensen
OBJECTIVE: To study the prognostic value of widespread pain and of musculoskeletal ultrasound (US) examination for subsequent treatment outcomes in patients with psoriatic arthritis (PsA). METHODS: An exploratory prospective cohort study enrolled PsA patients initiating biologic/conventional synthetic disease modifying anti-rheumatic drugs in routine care. Clinical-, US- and patient-reported measures were retrieved at baseline and after 4 months. Widespread non-arthritic pain (WP) was defined as Widespread Pain Index ≥4 with pain in ≥4/5 regions...
July 5, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29899668/retrocalcaneal-bursitis-precedes-or-accompanies-achilles-tendon-enthesitis-in-the-early-phase-of-rheumatoid-arthritis
#14
Takeshi Suzuki, Yuka Hidaka, Yu Seri
The consecutive reports and stored images of ultrasound examinations for 100 symptomatic ankles of 74 patients with rheumatoid arthritis (RA) were reviewed for the presence or absence of retrocalcaneal bursitis (RCB) and Achilles tendon enthesitis (ATE). The ankles were classified into 4 categories based on the presence or absence of RCB or ATE. The number of RCB(-)/ATE(-), RCB(+)/ATE(-), RCB(+)/ATE(+), and RCB(-)/ATE(+) ankles was 62, 16, 12, and 10, respectively. When classifying patients into early RA and established RA, the percentage of RCB(-)/ATE(+) ankles with early RA was significantly lower than that with established RA ( P  = ...
2018: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29858354/options-for-assessing-joints-and-entheses-in-psoriatic-arthritis-by-ultrasonography-and-magnetic-resonance-imaging-how-to-move-forward
#15
Lihi Eder, Sibel Z Aydin, Gurjit S Kaeley, Walter P Maksymowych, Mikkel Østergaard
Psoriatic arthritis (PsA) is a heterogeneous disease with various manifestations of musculoskeletal inflammation. Recent advances in imaging, including ultrasound (US) and magnetic resonance imaging (MRI), allow for the accurate evaluation of the extent of inflammation and damage in the peripheral joints, spine, and entheses. The development and validation of outcome measures are critical steps in creating standardized evaluations of musculoskeletal inflammation and damage in psoriatic patients. At the 2017 meeting of the Group for Research and Assessment of Psoriasis and PsA (GRAPPA), recent work on outcome measures from the GRAPPA US and MRI working groups was summarized...
June 2018: Journal of Rheumatology. Supplement
https://www.readbyqxmd.com/read/29844936/the-sonoanatomy-of-lumbar-erector-spinae-and-its-iliac-attachment-the-potential-substrate-of-the-iliac-crest-pain-syndrome-an-ultrasound-study-in-healthy-subjects
#16
Plamen Todorov, Rodina Nestorova, Anastas Batalov
Background: Iliac crest pain syndrome is a regional pain syndrome that has been identified in many patients with low back pain. Based on anatomical studies, it was suggested that the potential substrate of this syndrome might be the enthesis of the erector spinae muscle at the posterior medial iliac crest. As there have been no imaging studies of this important enthesis, our aim was to assess its characteristics by ultrasound. Methods: Erector spinae enthesis was first studied in a cadaver...
March 2018: Journal of Ultrasonography
https://www.readbyqxmd.com/read/29741671/similar-subclinical-enthesitis-in-celiac-and-inflammatory-bowel-diseases-by-ultrasound-suggests-a-gut-enthesis-axis-independent-of-spondyloarthropathy-spectrum
#17
Sibel Bakirci Ureyen, Cengiz Karacaer, Bilal Toka, Zeynep Erturk, Ahmet Tarik Eminler, Muhammed Kaya, Koray Tascilar, Ali Tamer, Ihsan Uslan, Esra Kurum, Dennis McGonagle, Sibel Zehra Aydin
Objective: Higher subclinical enthesitis on US has been reported in IBD and celiac disease, separately. The objective of this study was to compare IBD and celiac disease for enthesitis on US. Higher enthesitis scores in IBD compared with celiac disease would support a shared pathogenic mechanism between IBD and spondyloarthritis, whereas similar scores may suggest a general impact of gut inflammation on the enthesis. Methods: Patients with IBD, celiac disease and healthy controls (HCs) were recruited and 12 entheses were scanned by US, blind to the diagnosis and clinical assessment...
August 1, 2018: Rheumatology
https://www.readbyqxmd.com/read/29672804/imaging-features-of-the-juvenile-inflammatory-arthropathies
#18
REVIEW
Iwona Sudoł-Szopińska, Lennart Jans, Anne Grethe Jurik, Robert Hemke, Iris Eshed, Nathalie Boutry
We discuss the imaging of several juvenile inflammatory arthropathies including juvenile idiopathic arthritis, juvenile systemic lupus erythematosus, juvenile scleroderma, juvenile dermatomyositis, and chronic recurrent multifocal osteomyelitis. Juvenile idiopathic arthritis is the most common autoimmune chronic systemic disease of connective tissue in children. The remaining systemic juvenile connective tissue diseases are rare. However, they require early diagnosis and initiation of treatment to prevent injury, not only to the musculoskeletal system but also to the internal organs, and even death...
April 2018: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/29657139/power-doppler-ultrasound-evaluation-of-peripheral-joint-entheses-tendon-and-bursa-abnormalities-in-psoriatic-patients-a-clinical-study
#19
Yuanjiao Tang, Yujia Yang, Xi Xiang, Liyun Wang, Lingyan Zhang, Li Qiu
OBJECTIVE: To evaluate the prevalence rates of peripheral joint, enthesis, tendon, and bursa abnormalities by power Doppler (PD) ultrasonic examination in patients with psoriatic arthritis (PsA), psoriatic patients without clinical signs of arthritis (non-PsA psoriasis group), and healthy individuals, to detect subclinical PsA. METHODS: A total of 253 healthy volunteers, 242 non-PsA psoriatic patients, and 86 patients with PsA were assessed by 2-dimensional and power Doppler (PD) ultrasound...
June 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29626944/molecular-imaging-of-inflammatory-arthritis-and-related-disorders
#20
REVIEW
François Jamar, Annibale Versari, Filippo Galli, Frédéric Lecouvet, Alberto Signore
Rheumatic disorders comprise a number of diseases that range from benign, mildly symptomatic degenerative disease to severe systemic disorders such as giant-cell vasculitis with dramatic consequences such as acute blindness. The former is relatively common, whereas the latter is rare. In between, commonly encountered disorders such as rheumatoid arthritis and the various spondyloarthritides, with or without peripheral enthesitis, are daily challenges for the caring physician. Clinical evaluation is of utmost importance and is constantly described under the form of specialist guidelines in all parts of the world...
May 2018: Seminars in Nuclear Medicine
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