Whole-body magnetic resonance imaging vs. clinical evaluation of enthesitis in patients with spondyloarthritis

Four methods are available for evaluation of enthesitis, including tenderness, conventional radiography, ultrasonography, and magnetic resonance imaging (MRI). The exclusion criteria were as follows: (1) patients with serious primary diseases such as cardiocerebrovascular, digestive, hematopoietic system, liver, and renal disease; (2) athletes or practitioners in the fitness industry; (3) history of fracture, joint surgery, or joint replacement; (4) glucocorticoid use in the last 3 months; and (5) contraindications of MRI (pacemakers and so forth). Enthesitis was diagnosed when a high signal intensity on short TI inversion recovery (STIR) images was obtained with a corresponding signal loss on T1-weighted images within the bone marrow (bone marrow edema [BME]) or the surrounding soft tissue (soft tissue edema). Zhao et al[4] concluded that the combination of STIR and DWI would play significant roles in assessing the disease activity, Therefore, it is necessary to further explore the enthesitis and functional MRI results.