The Sound of Enthesis

The use of ultrasound for the assessment of enthesitis in patients with spondyloarthritis

“…The superficial location of most entheses allows scanning with high frequency linear probes of 14e18 MHz, which provide detailed images. 16 Power Doppler is used to detect increased blood flow in the enthesis, indicating neovascularity, which is associated with active inflammation. 17 Power Doppler is preferable over other Doppler methods because of its higher sensitivity.…”

Review of the Use of Ultrasound for the Diagnosis and Monitoring of Enthesitis in Psoriatic Arthritis

“…The higher the frequency, the greater the detail, but with high frequency comes a decrease in tissue penetration [17]. Fortunately, most entheses are superficial, and high-frequency probes such as those at 18 MHz can produce detailed images, resolving structures of 0.1 mm or less [2]. This enables detailed depiction of the fibrillar echotexture of the tendon or ligament, as well as pathological changes within these structures.…”

“…Ultrasound readily depicts multiple changes in the tendons or ligaments and in surrounding tissues in patients with psoriatic arthritis. However, a great deal of work remains to be done to help us understand which combination of ultrastructural changes is important and reliable for diagnosis and follow-up [1,2]. The following review summarizes the current use of ultrasound for the diagnosis and monitoring of enthesitis in psoriatic arthritis.…”

Paying attention to enthesitis in early untreated arthritis: MRI for the evaluation of enthesitis

“…However, ultrasonography (US) provides an innovative approach to investigate the entheses. The main entheseal abnormalities that can be detected by ultrasound include tendon oedema, tendon thickening, calcific deposits, bone erosion, enthesophytes, adjacent bursitis and increased blood perfusion 5 6. One of the disadvantages of US is that the ultrasound beams cannot penetrate bone, but as revealed by Paramarta et al 1 in this article, the entheses mostly involved in patients with SpA are superficial 8.…”

“…For instance, the thickness of the tendon, which could be one of the most important parameters of enthesitis,5 6 could hardly be measured in MRI 7. However, ultrasonography (US) provides an innovative approach to investigate the entheses.…”