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Arthritis Research & Therapy
Published in: Arthritis Research & Therapy 6/2011

Open Access 01-12-2011 | Research article

Ultrasound in the evaluation of enthesitis: status and perspectives

Authors: Frédérique Gandjbakhch, Lene Terslev, Fredrick Joshua, Richard J Wakefield, Esperanza Naredo, Maria Antonietta D'Agostino, OMERACT Ultrasound Task Force

Published in: Arthritis Research & Therapy | Issue 6/2011

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Abstract

Introduction

An increasing number of studies have applied ultrasound to the evaluation of entheses in spondyloarthritis patients. However, no clear agreement exists on the definition of enthesitis, on the number and choice of entheses to examine and on ultrasound technique, which may all affect the results of the examination. The objectives of this study were to first determine the level of homogeneity in the ultrasound definitions for the principal lesions of enthesitis in the published literature and second, to evaluate the metric properties of ultrasound for detecting enthesitis according to the OMERACT filter.

Methods

Search was performed in PUBMED and EMBASE. Both grey-scale and Doppler definitions of enthesitis, including describing features of enthesitis, were collected and metrological qualities of studies were assessed.

Results

After selection, 48 articles were analyzed. The definition of ultrasound enthesitis and elementary features varied among authors. Grey-scale enthesitis was characterized by increasing thickness (94% of studies), hypoechogenicity (83%), enthesophytes (69%), erosions (67%), calcifications (52%), associated bursitis (46%) and cortical irregularities (29%). Only 46% of studies reported the use of Doppler. High discrepancies were observed on frequency, type of probe and Doppler mode used. Face and content validity were the most frequently evaluated criteria (43%) followed by reliability (29%) and responsiveness (19%).

Conclusions

Ultrasound has evidence to support face, content validity and reliability for the evaluation of enthesitis, though there is a lack of well-reported methodology in most of the studies. Consensus on elementary lesions and standardization of exam is needed to determine the ultrasound definition of enthesitis in grey-scale and in Doppler for future applications.
Appendix
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Metadata
Title
Ultrasound in the evaluation of enthesitis: status and perspectives
Authors
Frédérique Gandjbakhch
Lene Terslev
Fredrick Joshua
Richard J Wakefield
Esperanza Naredo
Maria Antonietta D'Agostino
OMERACT Ultrasound Task Force
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 6/2011
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar3516

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