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Enthesitis.

Maria Antonietta D'Agostino¹, Ignazio Olivieri

¹Rheumatology Department, Ambroise Paré Hospital, UVSQ University, Boulogne-Billancourt, France.

Best Practice & Research. Clinical Rheumatology

|June 17, 2006

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Enthesitis, inflammation of tendon-bone junctions, is a key feature of spondyloarthritis. Peripheral enthesitis, especially in the lower limbs, is common and can be the sole early sign of this joint disease.

Area of Science:

Rheumatology
Immunology
Orthopedics

Background:

Enthesitis is a hallmark pathological feature of spondyloarthritis (SpA).
It affects various joint types and extra-articular sites, with peripheral lower limb enthesitis being most common.
Enthesitis can be the primary and sole clinical manifestation of SpA for extended periods.

Purpose of the Study:

To review the clinical significance of peripheral extra-articular enthesitis in spondyloarthritis.
To highlight enthesitis as the primary lesion in SpA, supported by advanced imaging.
To discuss the implications of understanding enthesitis in the context of SpA therapeutics.

Main Methods:

Literature review focusing on peripheral extra-articular enthesitis in spondyloarthritis.

Related Experiment Videos

Analysis of clinical observations regarding the frequency and impact of enthesitis.

Integration of findings from imaging modalities like ultrasound and MRI.

Main Results:

Peripheral extra-articular enthesitis is a frequent and defining characteristic across all spondyloarthritis forms.
Lower limb entheses, particularly the heel, are most commonly affected, causing variable pain levels.
Advanced imaging confirms enthesitis as the fundamental skeletal lesion in spondyloarthritis.

Conclusions:

Enthesitis is the primary pathological site in spondyloarthritis, impacting clinical presentation and disease understanding.
Accurate imaging of enthesitis aids in diagnosing and managing spondyloarthritis.
Therapeutic advancements, including anti-TNF agents, are transforming spondyloarthritis treatment, aligning with the recognition of enthesitis as the core lesion.