Enthesopathies and enthesitis. Part 1. Etiopathogenesis
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-specific clinical signs and results of laboratory tests. Imaging ex...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sciendo
2015-03-01
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| Series: | Journal of Ultrasonography |
| Subjects: | |
| Online Access: | http://jultrason.pl/index.php/issues/volume-15-no-60/enthesopathies-and-enthesitis-part-1-etiopathogenesis?aid=326 |
| Summary: | 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-specific 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, specific immunological changes and features in
imaging examinations that would allow the clinical diagnosis of enthesitis to be confirmed. The first part of the publication presents theories on the etiopathogenesis of
enthesopathies: inflammatory, 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 inflammation used in imaging medicine is specific 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 specific markers in imaging in order to establish
diagnosis as early as possible. |
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| ISSN: | 2084-8404 2451-070X |