Evaluation and monitoring of peripheral enthesitis in patients with axial spondyloarthritis using whole-body MRI
GUO Zikang
LI Boya
KONG Chunyu
LEI Xinwei
Abstract：Objective To analyze the distribution pattern of peripheral enthesitis in patients with axial spondyloar-thritis(axSpA)using whole-body MRI(WBMRI)and to monitor the response of enthesitis to treatment.Methods Thirty-seven patients(28 males and 9 females,mean age 33.5±8.2 years)diagnosed as axSpA were prospectively enrolled.All patients underwent WBMRI at initial examination(baseline)and follow up after drug treatment.Clinical information were collected at both baseline and follow-up.The number and distribution of specific enthesitis sites in the shoulders,anterior chest wall,pelvis,knees,and feet were identified on WBMRI images.Based on changes in enthesitis observed in the follow-up images,the patients were divided into the remission and non-remission groups.Independent sample t test,Mann-Whitney U test,and Fisher exact test were used to compare baseline clinical indicators between the two groups.Spearman correlation analysis was used to analyze the correlation between the number of peripheral enthesitis and clinical indicators.Results A total of 1 739 entheses were assessed in 37 patients.Baseline WBMRI showed 110 enthesitis sites(110/1 739,6.3％),including 32 in the anterior chest wall,21 in the shoulder,26 in the pelvis,21 in the knee,and 10 in the foot.The most common sites of enthesitis were the sternoclavicular joint of the anterior chest wall and the medial femoral condyle of the knee(17/110,15.4％).Follow-up WBMRI revealed 87(87/1 739,5.0％)enthesitis sites,with 25 in the anterior chest wall,11 in the shoulder,14 in the pelvis,20 in the knee,and 17 in the foot.The most common sites during follow-up was the medial femoral condyle of the knee(19/87,21.8％).The remission group(13 patients)had a lower baseline body mass index(BMI)and more enthesitis sites than the non-remission group(21 patients)(P＜0.05).The number of enthesitis sites on baseline WBMRI was not correlated with CRP,ESR,ASDAS-CRP,and disease duration(all P＞0.05).Conclusion WBMRI can reveal the overall distribution of peripheral enthesitis in patients with axSpA and has potential as an important imaging tool for evaluating clinical treatment efficacy.
Keywords：Axial spondyloarthritisWhole body magnetic resonance imagingEnthesitisAnkylosing spondylitis
Publication Date：2024-09-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 533-538 )