The aim of this study was to assess sensitivity and responsiveness of power Doppler ultrasound （PDUS） in detecting enthesitis for ankylosing spondylitis （AS） patients compared to clinical examinations. Twenty AS p...The aim of this study was to assess sensitivity and responsiveness of power Doppler ultrasound （PDUS） in detecting enthesitis for ankylosing spondylitis （AS） patients compared to clinical examinations. Twenty AS patients initiating etanerceptunderwent clinical and PDUS examinations of six bilateral entheseal sites at baseline and after 1, 2 and 3 months of treatment. Clinical and PDUS examinations identified at least one entheseal lesion in nine （45%） and 19 （95%） patients, respectively. Furthermore, of 240 entheseal sites examined in these 20 patients, PDUS detected 123 entheseal lesions （51.3% of sites）, compared with only 47 entheseal lesions （19.6%） detected by clinical examination （P〈0.05）. The entheseal lesions found on PDUS were most commonly identified by calcification （33.3%）, tendon edema （29.2%）, abnormal blood flow （25.8%）, a thickened tendon （22.1%）, cortical irregularity （12.9%）, bony erosions （9.6%） and bursitis at the tendon insertion to the bone cortex （7.1%）. Improvements in clinical symptoms and laboratory parameters, and significant decreases in PDUS scores were observed following treatment with etanereept. Improvements in PDUS scores continued during follow-up in patients who entered remission following treatment. In conclusion, PDUS improves detection of structural and inflammatory abnormalities of the enthesis in AS compared to physical examination. In addition, PDUS may be useful inascertaining medications.展开更多
Recognizing the mechanical origin of enthesitis/enthesopathy and the avulsion-nature of what had previously been considered erosions,it seems inappropriate to attribute it to stresses related to a person’s normal act...Recognizing the mechanical origin of enthesitis/enthesopathy and the avulsion-nature of what had previously been considered erosions,it seems inappropriate to attribute it to stresses related to a person’s normal activities.Conversely,sudden or unconditioned repetitive stresses appears the more likely culprit.Studies of enthesial reaction have lacked standardization as to findings present among individuals who appear to be healthy.Clinical evaluation by palpation and mani-pulation may be as effective as application of radiologic techniques.Recognition of the mechanical nature of the disease,including individuals with inflammatory arthritis suggests prescription of mechanical solutions that reduce stresses across the involved enthesis.展开更多
基金supported by the National Natural Science Foundation of China(No.81671608,81202350,81571586 and 81302559)Pfizer Competitive Grant(WS1620920)+5 种基金Jiangsu Six Talent Peaks Project(2015-WSN-074)Jiangsu 333 High Level Talents ProjectJiangsu Government Scholarship for Overseas StudiesJiangsu Health International Exchange Program sponsorshipNanjing Young Medical Talents ProjectNanjing Health Bureau Key Project(ZKX15018)
文摘The aim of this study was to assess sensitivity and responsiveness of power Doppler ultrasound （PDUS） in detecting enthesitis for ankylosing spondylitis （AS） patients compared to clinical examinations. Twenty AS patients initiating etanerceptunderwent clinical and PDUS examinations of six bilateral entheseal sites at baseline and after 1, 2 and 3 months of treatment. Clinical and PDUS examinations identified at least one entheseal lesion in nine （45%） and 19 （95%） patients, respectively. Furthermore, of 240 entheseal sites examined in these 20 patients, PDUS detected 123 entheseal lesions （51.3% of sites）, compared with only 47 entheseal lesions （19.6%） detected by clinical examination （P〈0.05）. The entheseal lesions found on PDUS were most commonly identified by calcification （33.3%）, tendon edema （29.2%）, abnormal blood flow （25.8%）, a thickened tendon （22.1%）, cortical irregularity （12.9%）, bony erosions （9.6%） and bursitis at the tendon insertion to the bone cortex （7.1%）. Improvements in clinical symptoms and laboratory parameters, and significant decreases in PDUS scores were observed following treatment with etanereept. Improvements in PDUS scores continued during follow-up in patients who entered remission following treatment. In conclusion, PDUS improves detection of structural and inflammatory abnormalities of the enthesis in AS compared to physical examination. In addition, PDUS may be useful inascertaining medications.
文摘Recognizing the mechanical origin of enthesitis/enthesopathy and the avulsion-nature of what had previously been considered erosions,it seems inappropriate to attribute it to stresses related to a person’s normal activities.Conversely,sudden or unconditioned repetitive stresses appears the more likely culprit.Studies of enthesial reaction have lacked standardization as to findings present among individuals who appear to be healthy.Clinical evaluation by palpation and mani-pulation may be as effective as application of radiologic techniques.Recognition of the mechanical nature of the disease,including individuals with inflammatory arthritis suggests prescription of mechanical solutions that reduce stresses across the involved enthesis.
