Gives good anatomical detail; can also reliably show joint effusions, synovial hypertrophy, inflammation and inflamed tendon sheaths and entheses
Typically, it is a chronic disease which affects the spinal column and sacroiliac joints, entheses
, and less commonly, the peripheral joints.
There have been various methods used over the years, although the standard that is currently considered the most specific is the CIASsification of Psoriatic ARthritis (CASPAR) criteria, which require the presence of inflammation in a joint, the spine, or entheses
plus at least 3 points from the following factors: presence of current psoriasis (2 points) or a personal or family history of psoriasis (1 point), dactylitis (1 point), pitting or ridging of the nails (1 point), a negative rheumatoid factor (1 point), and radiographic evidence of new bone formation (1 point).
About Spondyloarthritis Spondyloarthritis refers to a family of chronic, inflammatory diseases that share common clinical features, including inflammation of the joints and the entheses
(sites where ligaments and tendons attach to bones).
Subchondral bone marrow inflammation in the sacroiliac joints and at the entheses
is a characteristic histopathologic feature of the disease.
Additionally, STELARA improved soft tissue components of the disease, including dactylitis (inflammation of the finger or toe), enthesitis (inflammation of the entheses
, the sites where tendons or ligaments attach to bone) and skin component as measured by Psoriasis Area and Severity Index score (PASI) 75.
2007) Structure-function relationships of entheses
in relation to mechanical load and exercise.
In RA, the primary site of inflammation is synovial tissue, whereas in PsA the targets of inflammation--including the bone marrow and entheses
as well as synovium--are strikingly heterogeneous.
The rheumatological evaluation is directed at determining whether the pain is being referred from another site, or arising locally from the inert structures (bone and cartilage) or the contractile structures (ligaments, tendons, entheses
, bursa, capsule, etc.
While the spondyloarthritides characteristically affect the spine, there are situations where the inflammation affects the entheses
around peripheral joints rather than those around the spine (peripheral spondyloarthritis).
Prolotherapy is typically injected along distinct tender points at the entheses
of tendons or ligaments.
Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease characterized by inflammation of the entheses
and joints, which may lead to ankylosis.