Related Experiment Video
Updated: Jul 28, 2026
07:15
In vivo Macrophage Imaging Using MR Targeted Contrast Agent for Longitudinal Evaluation of Septic Arthritis
Published on: October 20, 2013
9.8K
Lessons Learned from Imaging on Enthesitis in Psoriatic Arthritis
Abdulla Watad1,2, Iris Eshed3,2, Dennis McGonagle4
1Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel.
The Israel Medical Association Journal : IMAJ
|November 30, 2017
Summary
Enthesitis, inflammation at tendon and ligament insertions, is key in psoriatic arthritis (PsA). Imaging techniques like ultrasonography and MRI help assess enthesitis, aiding PsA diagnosis and understanding.
Area of Science:
- Rheumatology
- Immunology
- Radiology
Background:
- Enthesitis, inflammation at tendon, ligament, or joint capsule insertions, is increasingly recognized as the primary site of joint inflammation in spondyloarthropathies, particularly psoriatic arthritis (PsA).
- Assessing enthesitis is challenging due to overlapping features between mechanical, degenerative, and inflammatory pathologies on clinical examination and imaging.
- Entheseal abnormalities are common in various arthropathies, including osteoarthritis (OA) and rheumatoid arthritis (RA), complicating differential diagnosis with PsA.
Purpose of the Study:
- To review the insights and implications of various imaging modalities for assessing enthesitis, primarily in PsA.
- To highlight the role of enthesitis in the pathogenesis and diagnosis of PsA and other related arthropathies.
- To discuss the diagnostic challenges and potential of imaging in differentiating inflammatory enthesitis from other conditions.
Main Methods:
- Review of current literature on imaging techniques for enthesitis assessment.
- Discussion of ultrasonography, magnetic resonance imaging (MRI), and nuclear medicine (PET, hrPET) in evaluating entheseal inflammation.
- Analysis of the association between imaging findings and clinical manifestations, including nail disease in PsA.
Main Results:
- Ultrasonography can detect subclinical entheseal abnormalities in patients with psoriasis, with potential predictive value for PsA.
- MRI is superior for assessing spinal polyenthesitis and diffuse peri-enthseal osteitis.
- Nuclear medicine (PET) serves as a research tool to differentiate PsA from OA by evaluating entheseal changes.
Conclusions:
- Imaging plays a crucial role in understanding and diagnosing enthesitis in PsA and other arthropathies.
- Ultrasonography and MRI offer valuable insights into entheseal inflammation, aiding in early detection and monitoring.
- Further research is needed to establish the longitudinal value of imaging-detected enthesitis for PsA prediction and management.
