Falsetti Paolo, Acciai Caterina, Lenzi Lucia, Frediani Bruno
Department of Clinical Medicine, Rheumatology Section, University of Siena, viale Bracci, 53100 Siena, Italy.
Mod Rheumatol. 2009;19(2):103-13. doi: 10.1007/s10165-008-0129-x. Epub 2008 Nov 12.
Enthesopathy is the pathologic change of the insertion of tendons, ligaments and joint capsules on the bone. It is a cardinal feature of spondyloarthropathies (SpA), but it can occur in other rheumatic disease. Recent studies using magnetic resonance imaging (MRI) and ultrasonography (US) have demonstrated that enthesopathy can often be asymptomatic, in both the axial and peripheral skeleton. Therefore, a systematic US study of peripheral entheses could be useful in the diagnostic process of patients with rheumatic diseases, in particular SpA. Recently, power Doppler US (PDUS) has been proved to be useful for differentiating mechanical/degenerative and inflammatory enthesopathy and for monitoring the efficacy of therapy. This article reviews the main histopathologic aspects of enthesopathy and describes the normal US features of enthesis and the basic US features of enthesopathy, in its various stages. The usefulness of US and PDUS in the diagnosis and assessment of enthesopathy is discussed on the basis of the literature and our experience.
附着点病是肌腱、韧带和关节囊在骨上附着处的病理变化。它是脊柱关节炎（SpA）的主要特征，但也可发生于其他风湿性疾病。最近使用磁共振成像（MRI）和超声检查（US）的研究表明，在中轴和外周骨骼中，附着点病通常可无症状。因此，对外周附着点进行系统的超声检查可能有助于风湿性疾病患者，尤其是SpA患者的诊断过程。最近，能量多普勒超声（PDUS）已被证明有助于鉴别机械性/退行性和炎性附着点病，并监测治疗效果。本文回顾了附着点病的主要组织病理学方面，并描述了附着点的正常超声特征以及附着点病各阶段的基本超声特征。基于文献和我们的经验，讨论了超声和能量多普勒超声在附着点病诊断和评估中的作用。
