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Citation Information : Journal of Ultrasonography. Volume 15, Issue 60, Pages 72-84, DOI: https://doi.org/10.15557/JoU.2015.0006
License : (CC BY-NC-ND 4.0)
Received Date : 16-April-2014 / Accepted: 07-May-2014 / Published Online: 13-September-2016
The pathologies of tendon and ligament attachments are called enthesopathies. One of its types is enthesitis which is a characteristic sign of peripheral spondyloarthropathy.
Clinical diagnosis of enthesitis is based on rather non-specifi c clinical signs and results of laboratory tests. Imaging examinations are highly promising. Numerous publications prove that enthesitis can be differentiated from other enthesopathic processes in an ultrasound examination or magnetic resonance imaging. However, some reports indicate the lack of histological criteria, specifi c immunological changes and features in imaging examinations that would allow the clinical diagnosis of enthesitis to be confi rmed. The fi rst part of the publication presents theories on the etiopathogenesis of enthesopathies: infl ammatory, mechanical, autoimmune, genetic and associated with the synovio-entheseal complex, as well as theories on the formation of enthesophytes: infl ammatory, molecular and mechanical. The second part of the paper is a review of the state-of-the-art on the ability of imaging examinations to diagnose enthesitis. It indicates that none of the criteria of infl ammation used in imaging medicine is specifi c for this pathology. As enthesitis may be the only symptom of early spondyloarthropathy (particularly in patients with absent HLA-B27 receptor), the lack of its unambiguous picture in ultrasound and magnetic resonance scans prompts the search for other signs characteristic of this disease and more specifi c markers in imaging in order to establish diagnosis as early as possible.
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