Promising New Imaging Modality for Enthesitis Whole body MRI can detect ethesitis in PsA and axSpA patients.

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Primary Source
Annals of the Rheumatic Diseases
Source Reference: Poggenborg RP, et al “Enthesitis in patients with psoriatic arthritis, axial spondyloarthritis and healthy subjects assessed by ‘head-to-toe’ whole-body MRI and clinical examination” Ann Rheum Dis 2015; DOI: 10.1136/annrheumdis-2013-204239.

Whole body magnetic resonance imaging (WBMRI), which allows assessment of all peripheral and axial joints and entheses in one examination, is a promising new imaging approach to detect enthesitis in patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), a new prospective, cross-sectional pilot study has found.

The study showed that “it is possible to detect enthesitis by “head-to-toe” WBMRI with moderate percentage agreement between MRI and clinical findings at the entheseal level”, according to Rene Penduro Poggenborg, Copenhagen Centre for Arthritis Research and Copenhagen Center for Rheumatology and Spine Diseases, Denmark, and colleagues.
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The study, published in the Annals of the Rheumatic Diseases, included 18 patients with PsA and 18 with axSpA, all with moderate to high disease activity. It also included 12 healthy controls (HS) without pain from peripheral joints or spine, family history of PsA, spondyloarthritis or rheumatoid arthritis, or personal history of psoriasis, anterior uveitis, inflammatory bowel disease, or heel pain.
Clinical enthesitis was defined as tenderness when the enthesis was palpitated with a pressure of the thumb until the tip of the nail bed blanched. Experienced clinicians examined study subjects at 18 peripheral and axial entheses at 35 different anatomical sites.
With MRI evaluations, enthesitis was defined as the presence of bone marrow edema, soft tissue edema, change in tendon thickness, erosions or enthesophytes in adjacent bones, and additional findings such as fluid around tendons or adjacent to bursa, alone or in combination.

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