Table 4 Description of enthesitis scoring system

2001

Cosentino [19]

PF

Y

N

grade l: thickening of enthesis (<2 mm thicker than the controlateral asymptomatic side), heterogeneous hypoechogenicity of enthesis and enthesophytosis.

grade 2: thickening of enthesis (>2 mm thicker than the controlateral asymptomatic side), heterogeneous hypoechogenicity of enthesis, and enthesophytosis.

grade 3: grade 2 with peritendinous oedema.

NA

U

2002

Balint [16]

GUESS:

A, PF (90°),PTPI, PTDI, Q (30°)

Y

N

GUESS score (0 to 36): Each item scores one point. total possible score on both lower limb is 36

superior pole of the patella- quadriceps tendon enthesis: quadriceps tendon thickness >=6.1mm, suprapatellar bursitis, superior pole of patella erosion, superior pole of patella enthesophyte

inferior pole of the patella-proximal patellar ligament enthesis: patellar ligament thickness > = 4 mm, inferior pole of patella erosion, inferior pole of patella enthesophyte

tibial tuberosity-distal patellar ligament enthesis: patellar ligament thickness > = 4 mm, infrapatellar bursitis, tibial tuberosity erosion, tibial tuberosity enthesophyte

superior pole of the calcaneus-achilles tendon enthesis: Achilles tendon thickness >=5.29 mm, retrocalcaneal bursitis, posterior pole of calcaneus erosion, posterior pole of calcaneus enthesophyte

inferior pole of the calcaneus -plantar aponeurosis enthesis: Plantar aponeurosis thickness >=4.4 mm, inferior pole of calcaneus erosion, inferior pole of calcaneus enthesophyte.

U

NA

2002

Falsetti [28]

wrist, elbow, shoulder, hip, knee, ankle, calcaneum

Y

N

each item scored according to a semi quantitative score: 1: mild,2: moderate,3:considerable

items scored: synovitis, tenosynovitis, enthesitis

U

NA

2003

D'Agostino [22]

A, PF, tibialis anterior tendon, CET, CFT, PT, Q, trochanter

Y

Y

stage 1: Vascularization at the cortical junction without abnormal findings in Grey-scale

stage 2a: Vascularization associated with swelling and/or decreased echogenicity at the cortical junction in Grey-scale

stage 3a: Same as stage 2a, plus erosions of cortical bone and/or calcification of enthesis, and optional surrounding bursitis

stage 2b: Abnormal findings in B mode as in stage 2a, but without vascularization

stage 3b: Abnormal findings in B mode as in stage 3a, but without vascularization

Y

NA

2003

Falsetti [11]

A, PF, retrocalcaneal bursae, subcalcaneal fat pad, cortical bone of posterior and inferior aspects of calcaneum

Y

N

Each inflammatory lesion was graded according to a semi-quantitative scale: grade 1: mild, grade 2: moderate, grade 3: considerable

NA

NA

2006

Kiris [37]

MASES *

N

Y

0 = absence, 1 = mild, 2 = moderate, 3 = severe

Y

NA

2007

Alcalde [14]

SEI:

A, PF (neutral flexion°),PTPI, PTDI, Q (60°)

Y

N

SEI = the total sum of SEI-A and SEI-C. the maximum SEI scoring is 76 points

SEI-A (0 to 36): each variable is scored as 0 (absence) or 1 (presence): thickening of tendon/aponeurosis, hypoechogenicity of tendon/aponeurosis, peritendinous/periaponeurotic oedema, bursitis (where applicable)

SEI-C (0 to 40): each variable is scored as 0 (absence) or 1 (presence): tendon tear, loss of thickness, tendon calcification, bone erosion.

U

NA

2008

De Miguel [23]

MASEI:

A (90°), PF (90°), PTPI and PTDI (70°), distal Q tendon, distal brachial triceps tendon (90°)

Y

Y

MASEI score (0 to 136 on both sides):

Calcifications were scored on a semi-quantitative score of 0 to 3

Doppler and erosions were scored as 0 or 3 points

Scores for tendon structure, tendon thickness and bursa were either 0 or 1.

Calcifications were examined at the area of the enthesis insertion, and scored as 0 if absent, or 1 if a small calcification or ossification with an irregularity of enthesis cortical bone profile was seen. Calcifications were given a score of 2 if there was clear presence of enthesophytes or if medium sized calcifications or ossification were observed. Lastly, they were classified as a 3 if large calcifications or ossifications were present. To simplify things, ossifications and enthesophytes at the enthesis were also included as calcifications.

Y

NA

2008

Hatemi [7]

GUESS **

Y

Y

GUESS score* + Doppler: one point for each enthese with vascularization. Cumulative score for Doppler (max = 10)

U

NA

2009

D'Agostino [20]

Q, PTPI, CET, A, PF

Y

Y

Grey-scale: hypoechogenicity/thickness: 0 to 1, calcification/enthesophyte: 0 to 1, erosion: 0 to 1

Doppler : (0 to 3): 0: no signal, 1: minimal (1 spot), 2: moderate (2 spot), 3: severe (> = 3 spots)or Doppler scored as 0 to 1 (absent-present)

Y

NA

2008

Mc Gonagle [44]

A (90°)

Y

N

spur (0 to 3):0 absence, 1: minimal, 2: moderate, 3: large

NA

NA

2009

Filippucci [13]

A

Y

Y

soft tissue inflammation (seven items): tendon hypoechogenicity, Entheseal hypoechogenicity, Bursal effusion, PDS signal at tendon level, PDS signal at entheseal level, PDS signal at bursal level

tissue damage (five items): Intratendineous calcifications, Entheseal calcifications, Enthesophytes, Bone erosions, Bone irregularities* (not used to calculate total score)

(1) a total score for soft tissue inflammation, which resulted from the sum of the scores assigned to the 7 US findings indicative of soft tissue inflammation, ranging from 0 to 7 with presence/absence data and from 0 to 14 with semiquantitative scores;

(2) a total score for tissue damage, which resulted from the sum of the scores assigned to the 4 US findings indicative of tissue damage, ranging from 0 to 4 with presence/absence data and from 0 to 8 with semiquantitative scores.

Y

NA

2009

Iagnocco [8]

A (neutral position)

Y

Y

All lesions scored on both a dichotomous scale (present/absent) and a 4-point semiquantitative scale (0 = absent, 1 = mild, 2 = moderate, 3 = severe)

enthesopathy: tendon hypoechogenicity at the level of bony attachment, tendon thickening at the at the level of bony attachment, intra-tendinous calcifications, enthesophytes, bony erosions, bony cortex irregularities, presence of Doppler signal at the level of bony attachment, presence of intratendinous Doppler signal

bursitis: enlargement of deep calcaneal bursa, enlargement of superficial calcaneal bursa

tendon lesion: both partial and full-thickness tendon lesions

NA

NA