Role for imaging in spondyloarthritis

Ran, Jun; Morelli, John N.; Xie, Ruyi; Zhang, Xiaoli; Liang, Xiaoqing; Liu, Xuanlin; Li, Xiaoming

doi:10.23736/s1824-4785.17.02981-8

Cited by 13 publications

(7 citation statements)

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“…The sensitivity of MRI allows the visualization of small, active inflammatory changes and lesions that are present early in the disease course [ 13 , 52 ]. MRI can be used to detect axial or peripheral enthesitis and, like ultrasound, can detect early signs of enthesitis and inflammatory lesions that are not detectable by radiography [ 53 , 54 ]. Lesions evident by MRI include thickening of tendons and ligaments, joint effusions and inflammation, bone erosions, enthesophytes, and intraosseous BME [ 27 , 52 ].…”

Section: Introductionmentioning

confidence: 99%

Musculoskeletal Imaging for Dermatologists: Techniques in the Diagnosis and Management of Psoriatic Arthritis

Gottlieb

Bakewell

Merola

2021

Dermatol Ther (Heidelb)

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Psoriatic arthritis is an inflammatory condition affecting up to 30% of patients with psoriasis. Patients may experience irreversible joint damage if not treated early, and diagnostic delays of even 6 months are associated with radiographic progression and impaired function. Therefore, early detection and intervention are of critical importance in patients with psoriatic arthritis. Given that psoriasis often precedes symptoms of psoriatic arthritis, dermatologists are uniquely positioned to identify patients with psoriatic arthritis early in their disease course, before permanent damage has occurred. Several screening tools have been developed to help dermatologists identify patients who may have psoriatic arthritis, but these tools may not capture patients with subclinical disease or quantify the type and severity of the underlying tissue insult, which is often the presenting sign of psoriatic arthritis. In these cases, a combination of clinical assessment and musculoskeletal imaging (e.g., ultrasound) is required. This review summarizes three common musculoskeletal imaging techniques used in the diagnosis and management of patients with psoriatic arthritis: conventional radiography, ultrasound, and magnetic resonance imaging. Further understanding of musculoskeletal imaging will assist dermatologists in making treatment decisions and allow them to have a more active role in the detection of psoriatic arthritis.

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Section: Introductionmentioning

confidence: 99%

Musculoskeletal Imaging for Dermatologists: Techniques in the Diagnosis and Management of Psoriatic Arthritis

Gottlieb

Bakewell

Merola

2021

Dermatol Ther (Heidelb)

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“…9 However, such semiquantitative morphological gradings focused mainly on the surrounding tissues instead of the entheses, which possess short T2s and show little or no signal with clinical sequences. 29 Quantitative diffusion-weighted imaging (DWI) acquired with routine sequences has shown promising results evaluating sacroiliac joints [30][31][32][33] ; however, its use in entheses and tendons is probably limited because of the lack of signal in these short T2 tissues. To the best of our knowledge, DWI has not been investigated for tendon or entheseal evaluation in the peripheral joints.…”

Section: Discussionmentioning

confidence: 99%

Achilles tendon and enthesis assessment using ultrashort echo time magnetic resonance imaging (UTE‐MRI) T1 and magnetization transfer (MT) modeling in psoriatic arthritis

Moazamian,

Athertya,

Dwek

et al. 2023

NMR in Biomedicine

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The purpose of this study is to investigate the use of ultrashort echo time (UTE) magnetic resonance imaging (MRI) techniques (T1 and magnetization transfer [MT] modeling) for imaging of the Achilles tendons and entheses in patients with psoriatic arthritis (PsA) compared with asymptomatic volunteers. The heels of twenty‐six PsA patients (age 59 ± 15 years, 41% female) and twenty‐seven asymptomatic volunteers (age 33 ± 11 years, 47% female) were scanned in the sagittal plane with UTE‐T1 and UTE‐MT modeling sequences on a 3‐T clinical scanner. UTE‐T1 and macromolecular proton fraction (MMF; the main outcome of MT modeling) were calculated in the tensile portions of the Achilles tendon and at the enthesis (close to the calcaneus bone). Mann–Whitney‐U tests were used to examine statistically significant differences between the two cohorts. UTE‐T1 in the entheses was significantly higher for the PsA group compared with the asymptomatic group (967 ± 145 vs. 872 ± 133 ms, p < 0.01). UTE‐T1 in the tendons was also significantly higher for the PsA group (950 ± 145 vs. 850 ± 138 ms, p < 0.01). MMF in the entheses was significantly lower in the PsA group compared with the asymptomatic group (15% ± 3% vs. 18% ± 3%, p < 0.01). MMF in the tendons was also significantly lower in the PsA group compared with the asymptomatic group (17% ± 4% vs. 20% ± 5%, p < 0.01). Percentage differences in MMF between the asymptomatic and PsA groups (−16.6% and −15.0% for the enthesis and tendon, respectively) were higher than the T1 differences (10.8% and 11.7% for the enthesis and tendon, respectively). The results suggest higher T1 and lower MMF in the Achilles tendons and entheses in PsA patients compared with the asymptomatic group. This study highlights the potential of UTE‐T1 and UTE‐MT modeling for quantitative evaluation of entheses and tendons in PsA patients.

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“…The weakness of this study is the use of conventional radiography, which shows the damage, but not the inflammation, present in enthesis. It is shown that the use of radiography for diagnosing enthesitis in early PsA is limited [10]. In cases where sacroiliac MRI is required in psoriatic patients, an evaluation of the ischium regions may help to investigate the enthesopathic changes that develop in these regions in the early stages of the disease.…”

Section: Variablesmentioning

confidence: 99%

Radiographic Ischial Enthesopathy in Patients with Psoriatic Arthritis

Bıtık

Dalgic

Kanbur

et al. 2022

Aktuelle Rheumatologie

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Background To investigate the prevalence of radiographic ischial entheseal lesions in patients with psoriatic arthritis (PsA) compared to patients with rheumatoid arthritis (RA). Patients and Methods Thirty-eight patients with PsA and 46 patients with RA were included. Anteroposterior radiographs of the pelvis and lateral foot were evaluated for entheseal lesions. The following entheseal sites were reviewed: os ischium, bilateral Achilles tendon and inferior calcaneus. Abnormalities such as cortical erosions and enthesophytes (irregular bony proliferation) were recorded. Results The frequency of enthesopathic changes in the ischial region was found to be statistically significantly higher in PsA patients compared with RA patients (50 and 28.3%, respectively, p=0.04). Enthesopathic changes of the calcaneus and Achilles tendon also occurred more frequently in PsA patients than in RA patients. Conclusion Radiographic entheseal lesions in the ischial region are more prevalent in PsA patients compared with RA patients with symptoms in that region. Furthermore, such enthesopathic changes in the ischium are observed as frequently as changes in the Achilles tendon. These findings regarding structural entheseal lesions in the pelvic region contribute to the knowledge of entheseal involvement in PsA.

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Role for imaging in spondyloarthritis

Cited by 13 publications

References 0 publications

Musculoskeletal Imaging for Dermatologists: Techniques in the Diagnosis and Management of Psoriatic Arthritis

Musculoskeletal Imaging for Dermatologists: Techniques in the Diagnosis and Management of Psoriatic Arthritis

Achilles tendon and enthesis assessment using ultrashort echo time magnetic resonance imaging (UTE‐MRI) T1 and magnetization transfer (MT) modeling in psoriatic arthritis

Radiographic Ischial Enthesopathy in Patients with Psoriatic Arthritis

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