From: Ultrasound in the evaluation of enthesitis: status and perspectives
Year | Authors | Enthesis studied | Grey-scale | Doppler mode | Scoring system | Reliability | Sensitivity to change |
---|---|---|---|---|---|---|---|
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 |