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2015 | 15 | 61 | 196–207

Article title

Entezopatie i zapalenie entez. Część II. Diagnostyka obrazowa

Content

Title variants

EN
Enthesopathies and enthesitis. Part 2: Imaging studies

Languages of publication

EN PL

Abstracts

EN
The pathologies of tendon and ligament attachments are called enthesopathies. Enthesitis is one of enthesopathies and it is considered a characteristic sign of rheumatic diseases from the spondyloarthritis group, including peripheral spondyloarthritis. Therefore, enthesitis has been included in a number of clinical classifications for diagnosing these diseases. Clinical diagnosis of enthesitis is based on rather non-specific clinical signs and results of laboratory tests. It is believed that imaging examinations might improve diagnosis, particularly because numerous papers prove that differentiating enthesitis from other enthesopathic processes is possible. On the other hand, a number of authors report the lack of specific signs in imaging as well as typical histological and immunological features that would enable confirmation of clinical diagnosis of enthesitis. The first part of the publication presented theories on the etiopathogenesis of enthesitis (inflammatory, mechanical, autoimmune and associated with the synovio-entheseal complex) as well as on the formation of enthesophytes (inflammatory, molecular and mechanical). This paper – the second part of the article, is a review of the state-of-the-art on the ability of imaging examinations to diagnose enthesitis. It turns out that none of the enthesitis criteria used in imaging examinations is specific for inflammation. As enthesitis may be the only symptom of early spondyloarthritis (particularly in patients with absent HLA-B27 antigen), the lack of its unambiguous picture in ultrasound and magnetic resonance imaging prompts the search for other signs characteristic of spondyloarthritis and more specific features in imaging in order to make a diagnosis as early as possible.
PL
Patologie przyczepów ścięgien i więzadeł są określane mianem entezopatii. Jednym z rodzajów entezopatii jest zapalenie (enthesitis). Uznaje się je za charakterystyczny objaw chorób reumatycznych z grupy spondyloartropatii (spondyloarthritis), w tym głównie spondyloartropatii obwodowych. Z tego powodu enthesitis włączono do szeregu klasyfikacji klinicznych, służących m.in. do rozpoznawania tych chorób. Klinicyści diagnozują enthesitis na podstawie mało specyficznych objawów oraz wyników badań laboratoryjnych. Duże nadzieje na poprawę możliwości diagnostycznych są wiązane z badaniami obrazowymi. Niektóre prace naukowe dowodzą możliwości różnicowania zapalenia entez z innymi procesami entezopatycznymi. Z drugiej strony szereg doniesień wskazuje na brak specyficznych zmian w badaniach obrazowych oraz typowych cech histologicznych i immunologicznych pozwalających na potwierdzenie klinicznego rozpoznania enthesitis. W pierwszej części publikacji przedstawiono teorie etiopatogenezy entezopatii (teorię zapalną, mechaniczną, kompleksu entezy i autoimmunologiczną) oraz koncepcje powstawania entezofitów (zapalną, molekularną i mechaniczną). W niniejszej, drugiej części zaprezentowano zaś przegląd wiedzy na temat możliwości badań obrazowych w rozpoznawaniu enthesitis. Jak się okazuje, żadne z kryteriów enthesitis stosowanych w badaniach obrazowych nie jest specyficzne dla zapalenia. Zważywszy na to, że enthesitis bywa jedynym objawem spondyloartropatii w początkowym okresie (zwłaszcza u chorych z nieobecnym antygenem HLA-B27), brak jednoznacznego obrazu w badaniach ultrasonograficznych i rezonansu magnetycznego wymaga poszukiwania innych objawów charakterystycznych dla spondyloartropatii i bardziej specyficznych markerów w badaniach obrazowych w celu jak najszybszego ustalenia rozpoznania.

Discipline

Year

Volume

15

Issue

61

Pages

196–207

Physical description

Contributors

  • Department of Radiology, Institute of Rheumatology, Spartańska 1, 02-637 Warsaw, Poland, tel./fax: +48 22 844 42 41. Department of Diagnostic Imaging, Second Faculty, Warsaw Medical University, Poland
  • Early Arthritis Clinic, Institute of Rheumatology, Warsaw, Poland
  • Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland. Department of Pathophysiology, Immunology, and Pathological Anatomy, Institute of Rheumatology, Warsaw, Poland
  • Department of Radiology, Institute of Rheumatology, Warsaw, Poland
  • Department of Radiology, Institute of Rheumatology, Warsaw, Poland
  • Department of Pathophysiology, Immunology, and Pathological Anatomy, Institute of Rheumatology, Warsaw, Poland

References

  • 1. Sudoł-Szopińska I, Kwiatkowska B, Prochorec-Sobieszek M, Maśliński W: Enthesopathies and enthesitis. Part 1. Etiopathogenesis. J Ultrason 2015; 15: 72–84.
  • 2. Balint PV, Kane D, Wilson H, McInnes IB, Sturrock RD: Ultrasonography of entheseal insertions in the Lower limb in spondyloartropathy. Ann Rheum Dis 2002; 61: 905–910.
  • 3. Goldring SR: Osteoimmunology and Bone Homeostasis: Relevance to pondyloarthritis. Curr Rheumatol Rep 2013; 15: 342.
  • 4. Czyrny Z: Sonographic and histological appearance of heel enthesopathy, what the „heel spurs” really are and what are their consequences. J Orthop Trauma Surg Rel Res 2010; 2: 23–36.
  • 5. Benjamin M, Toumi H, Ralphs JR, Bydder G, Best TM, Milz S: Where tendons and ligaments meet bone: attachment sites („entheses”) in relation to exercise and/or mechanical load. J Anat 2006; 208: 471–490.
  • 6. Benjamin M, McGonagle D: The anatomical basis for disease localization in seronegative spondyloarthropathy at entheses and related sites. J Anat 2001; 199: 503–526.
  • 7. Benjamin M, Ralphs JR: Fibrocartilage in tendons and ligaments – an adaptation to compressive load. J Anat 1998; 193: 481–494.
  • 8. Francois RJ, Braun J, Khan MA: Entheses and enthesitis: a histopathologic review and relevance to spondyloarthritides. Curr Opin Rheumatol 2001; 13: 255–264.
  • 9. Spadaro A, Iagnocco A, Perrotta FM, Modesti M, Scarno A, Valesini G: Clinical and ultrasonography assessment of peripheral enthesitis in ankylosing spondylitis. Rheumatology 2011; 50: 2080–2086.
  • 10. Maffulli N, Kader D: Tendinopathy of tendo Achillis. Tendinopathy of tendo Achillis. J Bone Joint Surg 2002; 84: 1–8.
  • 11. Czyrny Z: Diagnostic anatomy and diagnostics of enthesal pathologies of the rotator cuff. J Ultrason 2012; 12: 178–187.
  • 12. Dębek A, Nowicki P, Czyrny Z: Ultrasonographic diagnostics of pain in the lateran cubital compartment and proximal forearm. J Ultrason 2012;12: 188–201.
  • 13. D’Agostino MA: Enthesitis. Best Pract Res Clin Rheumatol 2006; 20: 473–486.
  • 14. D’Agostino MA, Aegerter P, Bechara K, Salliot C, Judet O, Chimenti MS et al.: How to diagnose spondyloarthritis early? Accuracy of peripheral enthesitis detection by power doppler ultrasonography. Ann Rheum Dis 2011; 70: 1433–1440.
  • 15. Balint PV, Kane D, Wilson H, McInnes IB, Sturrock RD: Ultrasonography of entheseal insertions in the lower limb in spondyloarthropathy. Ann Rheum Dis 2002; 61: 905–910.
  • 16. D’Agostino MA, Said-Nahal R, Hacquard-Bouder C, Brasseur JL, Dougados M, Breban M: Assessment of peripheral enthesitis in the spondyloarthropathies by ultrasonogfraphy combined with power Doppler: a cross-sectional study. Arthritis Rheum 2003; 48: 523–533.
  • 17. Sudoł-Szopińska I, Zaniewicz-Kaniewska K, Kwiatkowska B: Spectrum of ultrasound pathologies of Achilles tendon, plantar aponeurosis and flexor digiti brevis entheses in patients with clinically suspected enthesitis. Pol J Radiol 2014; 79: 402–408.
  • 18. D’Agostino MA, Palazzi C, Olivieri I: Entheseal involvement. Clin Exp Rheumatol 2009; 27 (Suppl. 55): S50–S55.
  • 19. Genc H, Cakit BD, Tuncbilek I, Erdem HR: Ultrasonographic evaluation of tendons and enthesal sites in rheumatoid arthritis: comparison with ankylosing spondylitis and healthy subjects. Clin Rheumatol 2005;24: 272–277.
  • 20. Feydy A, Lavie-Brion MC, Gossec L, Lavie F, Guerini H, Nguyen C et al.: Comparative study of MRI and power Doppler ultrasonography of the heel in patients with spondyloarthritis with and without heel pain and in controls. Ann Rheum Dis 2012; 71: 498–503.
  • 21. Hermann KG, Baraliakos X, van der Heijde DM, Jurik AG, Landewé R, Marzo-Ortega H et al.: Descriptions of spinal MRI lesions and definition of a positive MRI of the spine in axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI study group. Ann Rheum Dis 2012; 71: 1278–1288.
  • 22. Bollow M, Fischer T, Reisshauer H, Backhaus M, Sieper J, Hamm B et al.: Quantitative analyses of sacroiliac biopsies in spondyloarthropathies: T cells and macrophages predominate in early and active sacroiliitiscellularity correlates with the degree of enhancement detected by magnetic resonance imaging. Ann Rheum Dis 2000; 59: 135–140.
  • 23. Appel H, Loddenkemper C, Grozdanovic Z, Ebhardt H, Dreimann M, Hempfi ng A et al.: Correlation of histopathological findings and magnetic resonance imaging in the spine of patients with ankylosing spondylitis. Arthritis Res Ther 2006; 8: R143.
  • 24. Eshed I, Bollow M, McGonagle D, Tan AL, Althoff CE, Asbach P et al.: MRI of enthesitis of the appendicular skeleton in spondyloarthritis. Ann Rheum Dis 2007; 66: 1553–1559.
  • 25. McGonagle D, Gibbon W, O’Connor P, Green M, Pease C, Emery P: Characteristic magnetic resonance imaging entheseal changes of knee synovitis in spondyloarthropathy. Arthritis Rheum 1998; 41: 694–700.
  • 26. Benjamin M, McGonagle D: Entheses, enthesitis and enthesopathy. ARC, Topical Reviews 2009; 4: 1–6.
  • 27. Pierre-Jerome C, Moncayo V, Terk M: MRI of the Achilles tendon: a comprehensive review of the anatomy, biomechanics, and imaging of overuse tendinopathies. Acta Radiol 2010; 51: 438–454.
  • 28. Olivieri I, Barozzi L, Padula A, De Matteis M, Pierro A, Cantini F et al.: Retrocalcaneal bursitis in spondyloarthropathy: assessment with ultrasonography and magnetic resonance imaging. J Rheumatol 1998; 25: 1352–1357.
  • 29. Benjamin M, McGonagle D: The enthesis organ concept and its relevance to the spondyloarthropathies. In: Lopez-Larrea C, Diaz-Pena R (eds.): Molecular mechanisms of spondyloarthropathies. Springer-Science + Business Media LLC, New York 2009: 57–70.
  • 30. Benjamin M, McGonagle D: Histopathologic changes at „synovio-entheseal complexes” suggesting a novel mechanizm for synovitis in osteoarthritis and spondylarthritis. Arthritis Rheum 2007; 56: 3601–3609.
  • 31. Sudoł-Szopińska I, Kontny E, Zaniewicz-Kaniewska K, Prohorec-Sobieszek M, Saied F, Maśliński W: Role of infl ammatory factors and adipose tissue in pathogenesis of rheumatoid arthritis and osteoarthritis. Part I: Rheumatoid adipose tissue. J Ultrason 2013; 13: 192–201.
  • 32. Sudoł-Szopińska I, Hrycaj P, Prohorec-Sobieszek M: Role of infl ammatory factors and adipose tissue in pathogenesis of rheumatoid arthritis and osteoarthritis. Part II: Infl ammatory background of osteoarthritis. J Ultrason 2013;13 (54): 319–328.
  • 33. Benjamin M, Redman S, Buttner A, Amin A, Moriggl B, Brenner E et al.: Adipose tissue at entheses: the rheumatological implications of its distribution. A potential site of pain and stress dissipation? Ann Rheum Dis 2004; 63: 1549–1555.
  • 34. Gandjbakhch F, Terslev L, Joshua F, Wakefi eld RJ, Naredo E, D’Agostino MA: Ultrasound in the evaluation of enthesis: status and perspectives. Arthritis Res Ther 2011; 13: R188.

Document Type

review

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.psjd-44e66bb2-a004-4963-9fd4-f0b00ce07e2b
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