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...

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Main Authors: Iwona Sudoł-Szopińska, Brygida Kwiatkowska, Monika Prochorec-Sobieszek, Włodzimierz Maśliński
Format: Article
Language:English
Published: Sciendo 2015-03-01
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
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author Iwona Sudoł-Szopińska
Brygida Kwiatkowska
Monika Prochorec-Sobieszek
Włodzimierz Maśliński
author_facet Iwona Sudoł-Szopińska
Brygida Kwiatkowska
Monika Prochorec-Sobieszek
Włodzimierz Maśliński
author_sort Iwona Sudoł-Szopińska
collection DOAJ
description 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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spelling doaj.art-390bd6664158412f86cd7291d82d62f72022-12-22T03:41:37ZengSciendoJournal of Ultrasonography2084-84042451-070X2015-03-011560728410.15557/JoU.2015.0006Enthesopathies and enthesitis. Part 1. EtiopathogenesisIwona Sudoł-Szopińska0Brygida Kwiatkowska1Monika Prochorec-Sobieszek2Włodzimierz Maśliński3Department of Radiology, Institute of Rheumatology, Warsaw, Poland; Department of Diagnostic Imaging, Second Faculty, Warsaw Medical University, PolandEarly Arthritis Clinic, Institute of Rheumatology, Warsaw, PolandDepartment of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland; Department of Pathophysiology, Immunology, and Pathological Anatomy, Institute of Rheumatology, Warsaw, PolandDepartment of Pathophysiology, Immunology, and Pathological Anatomy, Institute of Rheumatology, Warsaw, PolandThe 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.http://jultrason.pl/index.php/issues/volume-15-no-60/enthesopathies-and-enthesitis-part-1-etiopathogenesis?aid=326enthesopathyenthesitisetiopathogenesisspondyloarthropathiesrheumatic diseases
spellingShingle Iwona Sudoł-Szopińska
Brygida Kwiatkowska
Monika Prochorec-Sobieszek
Włodzimierz Maśliński
Enthesopathies and enthesitis. Part 1. Etiopathogenesis
Journal of Ultrasonography
enthesopathy
enthesitis
etiopathogenesis
spondyloarthropathies
rheumatic diseases
title Enthesopathies and enthesitis. Part 1. Etiopathogenesis
title_full Enthesopathies and enthesitis. Part 1. Etiopathogenesis
title_fullStr Enthesopathies and enthesitis. Part 1. Etiopathogenesis
title_full_unstemmed Enthesopathies and enthesitis. Part 1. Etiopathogenesis
title_short Enthesopathies and enthesitis. Part 1. Etiopathogenesis
title_sort enthesopathies and enthesitis part 1 etiopathogenesis
topic enthesopathy
enthesitis
etiopathogenesis
spondyloarthropathies
rheumatic diseases
url http://jultrason.pl/index.php/issues/volume-15-no-60/enthesopathies-and-enthesitis-part-1-etiopathogenesis?aid=326
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AT monikaprochorecsobieszek enthesopathiesandenthesitispart1etiopathogenesis
AT włodzimierzmaslinski enthesopathiesandenthesitispart1etiopathogenesis