Journal articles: 'Enthesitis-related arthritis'

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Hahn, Youn-Soo. "Enthesitis-related Arthritis." Journal of Rheumatic Diseases 25, no. 4 (2018): 221. http://dx.doi.org/10.4078/jrd.2018.25.4.221.

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Aggarwal, Amita, and Durga Prasanna Misra. "Enthesitis-related arthritis." Clinical Rheumatology 34, no. 11 (August 2, 2015): 1839–46. http://dx.doi.org/10.1007/s10067-015-3029-4.

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Shenoy, Sajjan, and Amita Aggarwal. "268. Subclinical Sonologic Enthesitis in Juvenile Idiopathic Arthritis–Enthesitis-Related Arthritis." Rheumatology 53, suppl_1 (April 2014): i159—i160. http://dx.doi.org/10.1093/rheumatology/keu123.002.

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Rosenthal, Ayelet, and Ginger Janow. "Enthesitis-Related Juvenile Idiopathic Arthritis." Pediatrics in Review 40, no. 5 (May 2019): 256–58. http://dx.doi.org/10.1542/pir.2017-0177.

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Mistry, Rutviz Rajendra, Pallavi Patro, Vikas Agarwal, and Durga Prasanna Misra. "Enthesitis-related arthritis: current perspectives." Open Access Rheumatology: Research and Reviews Volume 11 (January 2019): 19–31. http://dx.doi.org/10.2147/oarrr.s163677.

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Weiss, Pamela F. "Update on enthesitis-related arthritis." Current Opinion in Rheumatology 28, no. 5 (September 2016): 530–36. http://dx.doi.org/10.1097/bor.0000000000000313.

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Weiss, Pamela F., Andrew J. Klink, Edward M. Behrens, David D. Sherry, Terri H. Finkel, Chris Feudtner, and Ron Keren. "Enthesitis in an inception cohort of enthesitis-related arthritis." Arthritis Care & Research 63, no. 9 (August 29, 2011): 1307–12. http://dx.doi.org/10.1002/acr.20508.

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Singh, Yogesh Preet, Vikas Agarwal, Narendra Krishnani, and Ramnath Misra. "Enthesitis-related arthritis in Kikuchi–Fujimoto disease." Modern Rheumatology 18, no. 5 (October 2008): 492–95. http://dx.doi.org/10.3109/s10165-008-0076-6.

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ENAZI, ABDULLATIF AL, KIM MORISHITA, ROBYN A. CAIRNS, LORI TUCKER, DAVID CABRAL, ROSS PETTY, and JAIME GUZMAN. "Early Atlantoaxial Subluxation in Enthesitis-related Arthritis." Journal of Rheumatology 41, no. 6 (June 2014): 1190–91. http://dx.doi.org/10.3899/jrheum.131206.

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Kan, J. Herman. "Juvenile idiopathic arthritis and enthesitis-related arthropathies." Pediatric Radiology 43, S1 (March 2013): 172–80. http://dx.doi.org/10.1007/s00247-012-2586-9.

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Nienhuis, Syert Luidolf, and Robin Eric Westerbeek. "Enthesitis in a 16-Year-Old Boy with M694V Mutation." Case Reports in Medicine 2016 (2016): 1–3. http://dx.doi.org/10.1155/2016/5869250.

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Introduction. FMF (Familial Mediterranean Fever) is characterized by recurrent attacks of fever and articular pain. Enthesitis is the hallmark of pain in spondyloarthropathy. Literature suggests association of M694V mutation and enthesitis. We report a case of a 16-year-old boy with enthesitis and FMF. Case Presentation. A 16-year-old boy of Turkish origin with a history of FMF presented with localized tenderness of the heel and severe disability. MRI showed an enthesitis of the plantar fascia. Standard treatment of FMF and enthesitis was not successful. After referral to a university hospital and expert opinion of a professor in rheumatology, this enthesitis should be treated as an enthesitis related arthritis. With this treatment, our patient fully recovered 8 months after the onset of the disease symptoms. Conclusion. M694V mutation related enthesitis should be considered in FMF patients with enthesitis. We would suggest treatment for enthesitis related arthritis in similar cases. This is of clinical importance because the treatment is different from treatment of enthesitis or articular pain caused by FMF.

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Fisher, Corinne, Yiannis Ioannou, Margaret HallCraggs, and Debajit Sen. "Enthesitis Related Arthritis; a New Era of Understanding." Annals of Paediatric Rheumatology 1, no. 1 (2012): 8. http://dx.doi.org/10.5455/apr.011520120733.

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Li, S. C. "Enthesitis-related Juvenile Inflammatory Arthritis: Long-term Outcome." AAP Grand Rounds 17, no. 2 (February 1, 2007): 14–15. http://dx.doi.org/10.1542/gr.17-2-14.

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Akkus, K., N. Aktay Ayaz, L. Ozcakar, E. Demirkaya, R. Topaloglu, A. Bakkaloglu, and S. Ozen. "Features of enthesitis related arthritis in Turkish children." Pediatric Rheumatology 6, Suppl 1 (2008): P72. http://dx.doi.org/10.1186/1546-0096-6-s1-p72.

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Gmuca, Sabrina, and Pamela F. Weiss. "Evaluation and Treatment of Childhood Enthesitis-Related Arthritis." Current Treatment Options in Rheumatology 1, no. 4 (September 29, 2015): 350–64. http://dx.doi.org/10.1007/s40674-015-0027-2.

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Weiss, Pamela F., Nancy A. Chauvin, Andrew J. Klink, Russell Localio, Chris Feudtner, Diego Jaramillo, Robert A. Colbert, David D. Sherry, and Ron Keren. "Detection of Enthesitis in Children With Enthesitis-Related Arthritis: Dolorimetry Compared to Ultrasonography." Arthritis & Rheumatology 66, no. 1 (December 30, 2013): 218–27. http://dx.doi.org/10.1002/art.38197.

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Wervers, Kim, Jolanda J. Luime, Ilja Tchetverikov, Andreas H. Gerards, Marc R. Kok, Cathelijne W. Y. Appels, Wiebo L. van der Graaff, et al. "Influence of Disease Manifestations on Health-related Quality of Life in Early Psoriatic Arthritis." Journal of Rheumatology 45, no. 11 (July 1, 2018): 1526–31. http://dx.doi.org/10.3899/jrheum.171406.

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Objective.Psoriatic arthritis (PsA) is a multifaceted disease. Affecting joints, skin, entheses, and dactylitis, its effect on health-related quality of life (HRQOL) could be substantial. We aim to assess HRQOL in patients newly diagnosed with PsA and analyze its associations with disease manifestations.Methods.Data collected at time of diagnosis from patients with PsA included in the Dutch south-west Early Psoriatic Arthritis cohort (DEPAR) study were used. HRQOL was assessed using 8 domains of the Medical Outcomes Study Short Form-36 (SF-36) questionnaire. Patients were classified based on primary manifestation in arthritis subtypes (i.e., mono-, oligo-, or polyarthritis) and other subtypes (i.e., enthesitis, dactylitis, and axial disease). In all patients, presence of arthritis, enthesitis, dactylitis, psoriasis, and chronic inflammatory back pain was determined. Multivariable linear regression was used to determine associations of PsA manifestations with HRQOL.Results.Of 405 patients, primary manifestation was peripheral arthritis in 320 (78 monoarthritis, 151 oligoarthritis, and 91 polyarthritis), enthesitis in 37, axial disease in 9, and dactylitis in 39. Mean scores of SF-36 domains were lower than the Dutch reference population and similar across arthritis subtypes. A higher number of enthesitis locations and tender joints, and presence of chronic back pain, were independently associated with worse SF-36 scores. Psoriasis and dactylitis were not associated with worse scores.Conclusion.HRQOL was diminished in PsA at time of diagnosis compared to the Dutch reference population, and tender joints, enthesitis at clinical examination, and back pain as indicators of pain affected HRQOL.

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Tay, S. H., J. Y. Leong, M. Wasser, A. J. M. Lim, P. Chen, J. G. Yeo, T. Arkachaisri, and S. Albani. "SAT0496 INTERROGATING THE CIRCULATORY IMMUNE ARCHITECTURE OF ENTHESITIS-RELATED ARTHRITIS." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1204.1–1204. http://dx.doi.org/10.1136/annrheumdis-2020-eular.5125.

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Background:Enthesitis-related arthritis (ERA) is one of the most common subtype of juvenile idiopathic arthritis (JIA) in Asia1. It carries a poor prognosis, but limited knowledge of its pathogenesis hampers clinical diagnosis and treatment.Objectives:We hypothesise multiple aberrations from the healthy immunome culminating in an imbalance between the immune effector and regulatory cell subsets as key for driving ERA pathogenesis. Thus, we employed a comprehensive high-dimensional interrogative strategy using mass cytometry to assess the ERA immune architecture2.Methods:We examined peripheral blood mononuclear cells from 30 ERA patients (15 with active sacroilitis, 15 without active sacroilitis) within the first two years of disease and 30 healthy paediatric controls with mass cytometry, using two extensive antibody panels encompassing key lineage and functional markers. Dimensional reduction and unsupervised clustering were performed to identify immune cell subsets differentially present in ERA patients. Manual gating was performed to further describe observed differences in subset frequencies. These subsets were statistically evaluated with reference to the healthy cohort and their association with disease activity determined.Results:We identified broad differences in the ERA circulatory immune architecture that involved both innate and adaptive immune cell populations, notably with the enrichment of naive CD4+ T cells as well as depletion of cytolytic NK cells (CD56dimCD16+). The chemotactic profiles of their subsets also differed in ERA patients, which underscores their migratory capacity and hence potential effector role in the ERA arthritic microenvironment. In addition, there were some dissimilarities in the circulatory immunome of ERA patients with active sacroiliitis as compared to those without, which alludes to a possible mechanistic basis behind the disease complication.Conclusion:This is the first study, via deep parameterisation afforded by mass cytometry, to demonstrate a concomitant dysregulation of both innate and adaptive immune cell subsets in ERA patients. Further mechanistic studies of these immune cell subsets and their functional networks will inform the development of diagnostic and prognostic markers that can reliably predict clinical fate in ERA, thereby complementing clinical assessment in the care of ERA patients.References:[1]Arkachaisri et al. Paediatric rheumatology clinic in Southeast Asia: are we different?Rheumatology (Oxford). 2017.[2]Tay et al. Immunomics in pediatric rheumatic diseases.Front Med (Lausanne). 2019.Disclosure of Interests:None declared

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PAGNINI, ILARIA, SARA SAVELLI, MARCO MATUCCI-CERINIC, CLAUDIO FONDA, ROLANDO CIMAZ, and GABRIELE SIMONINI. "Early Predictors of Juvenile Sacroiliitis in Enthesitis-related Arthritis." Journal of Rheumatology 37, no. 11 (September 1, 2010): 2395–401. http://dx.doi.org/10.3899/jrheum.100090.

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Objective.To identify early predictors of sacroiliac (SI) involvement in a cohort of patients with enthesitis-related arthritis (ERA).Methods.During a 7-year followup period, all consecutive patients fulfilling the ILAR classification criteria for ERA were enrolled. Data collected included demographic, clinical and laboratory variables at disease onset, at the onset of inflammatory back pain, and at the last available followup visit. Pelvis radiographs and dynamic magnetic resonance imaging (MRI) scans for SI joints were obtained simultaneously in all patients who developed inflammatory back pain.Results.Fifty-nine children with ERA were studied; 40 male, 19 female; median age at disease onset 9 years 4 months (range 6 yrs 6 mo – 13 yrs 3 mo). At a median interval after disease onset of 1 year 3 months, 21 children reported symptoms of inflammatory back pain. In all cases, radiographs of SI joints were negative, while dynamic MRI revealed acute sacroiliitis in 17 cases. Multivariate analysis showed that the early predictors of SI were the number of active joints (p < 0.03) and the number of active entheses (p < 0.001) at onset.Conclusion.In our cohort, roughly 30% of children with ERA/juvenile idiopathic arthritis develop clinical and MRI evidence of sacroiliitis, detectable with dynamic MRI as early as 1 year after disease onset. Additional data from larger case series are needed to assess the specificity and sensitivity of this technique in the early phase of the disease and to confirm the rate of SI involvement reported in this cohort.

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Colbert, Robert A. "Classification of juvenile spondyloarthritis: enthesitis-related arthritis and beyond." Nature Reviews Rheumatology 6, no. 8 (July 6, 2010): 477–85. http://dx.doi.org/10.1038/nrrheum.2010.103.

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Sukumaran, Sukesh, Katherine Marzan, Bracha Shaham, and Joseph A. Church. "A Child with X-Linked Agammaglobulinemia and Enthesitis-Related Arthritis." International Journal of Rheumatology 2011 (2011): 1–3. http://dx.doi.org/10.1155/2011/175973.

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X-linked agammaglobulinemia (XLA) is a primary immune deficiency characterized by recurrent bacterial infections and profoundly depressed serum immunoglobulin levels and circulating mature B cells. We describe a 12-year-old boy with XLA and enthesitis-related arthritis (ERA). To date, there has been a paucity of reports of noninfectious inflammatory arthritis in children with XLA. This case illustrates that functional B cells and/or immunoglobulin are not required for ERA pathogenesis. In addition, this case suggests a possible link between immune deficiency, immune dysregulation, and rheumatic illness.

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Elalouf, Ofir, Sibel Bakirci Ureyen, Zahi Touma, Melanie Anderson, Gurjit S. Kaeley, Sibel Z. Aydin, and Lihi Eder. "Psoriatic Arthritis Sonographic Enthesitis Instruments: A Systematic Review of the Literature." Journal of Rheumatology 46, no. 1 (July 15, 2018): 43–56. http://dx.doi.org/10.3899/jrheum.171466.

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Objective.As part of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) ultrasound working group, we performed a systematic review of the literature to assess the evidence and knowledge gaps in scoring instruments of enthesitis in psoriatic arthritis (PsA).Methods.A systematic search of PubMed, EMBase, and Cochrane databases was performed. The search strategy was constructed to find original publications containing terms related to ultrasound, enthesitis, spondyloarthritis (SpA) or PsA. Data extraction focused on the properties of the sonographic enthesitis instruments used in each study following components of the Outcome Measures in Rheumatology (OMERACT) filter: feasibility, test-retest reliability, construct validity as related to clinical assessment of enthesitis, biomarkers of inflammation and imaging of enthesitis by other modalities, discriminative validity, and responsiveness to treatment.Results.Fifty-one of 310 identified manuscripts were included. Only 1 scoring instrument of enthesitis was specifically developed and validated in patients with PsA. Only 18 (35%) of the studies involved patients with PsA, while the remaining studies focused on SpA. In PsA, construct validity was assessed using biomarkers and clinical examination in 1 (2%) and 11 (21.5%) of the studies, respectively, whereas no studies used imaging for the same purpose. Only 2 (4%) of the studies assessed discriminative validity in PsA. Responsiveness to treatment was assessed in 7 studies, none of which included patients with PsA.Conclusion.Although sonographic enthesitis scoring instruments have been developed for SpA, only a few have been validated in PsA. None of them passed the OMERACT filter in patients with PsA. Additional research is required before endorsing a specific instrument for the assessment of enthesitis in patients with PsA.

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Aeder, Lita, and Karen B. Onel. "Update on Juvenile Spondyloarthritis." Pediatrics In Review 42, no. 11 (November 1, 2021): 581–89. http://dx.doi.org/10.1542/pir.2020-000810.

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Spondyloarthritis (SpA) is a blanket term encompassing entities such as enthesitis-related arthritis, nonradiographic axial SpA, and ankylosing spondylitis. These diseases share many clinical features, including a predilection for inflammation of the entheses and the sacroiliac joints. The nomenclature is based on the evolution of the classification of the disease and the age of the patient. SpA has a prevalence of approximately 1% of the population of the United States, with 10% to 20% of patients experiencing the onset during childhood. Children with onset of arthritis before age 16 years are classified as having juvenile idiopathic arthritis. Children with enthesitis and/or sacroiliitis are further classified as belonging to the enthesitis-related arthritis subtype of juvenile idiopathic arthritis. The initial manifestations can be subtle and will usually include a peripheral pattern of arthritis and enthesitis. It may take several years for axial disease to develop in children. Except for an association with the human leukocyte antigen (HLA-B27) serotype, there are no laboratory markers for the disease, and the radiographic findings are often negative. A careful clinical evaluation for evidence of inflammation in the entheses and the joints and a search for comorbidities are required. Magnetic resonance imaging facilitates the early detection of sacroiliitis, an important feature that may be clinically silent. Because recent studies indicate that earlier introduction of therapy can help achieve better outcomes, rapid identification and treatment of children with SpA is essential.

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McInnes, Iain B., Lluís Puig, Alice B. Gottlieb, Christopher T. Ritchlin, Michael Song, Yin You, Shelly Kafka, G. James Morgan, Proton Rahman, and Arthur Kavanaugh. "Association Between Enthesitis and Health-related Quality of Life in Psoriatic Arthritis in Biologic-naive Patients from 2 Phase III Ustekinumab Trials." Journal of Rheumatology 46, no. 11 (April 1, 2019): 1458–61. http://dx.doi.org/10.3899/jrheum.180792.

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Objective.Evaluate enthesitis, physical function, and health-related quality of life (HRQOL) among patients with psoriatic arthritis (PsA) who are naive to anti–tumor necrosis factor agents.Methods.In PSUMMIT 1 and 2, patients with PsA were randomized to placebo or ustekinumab 45 mg or 90 mg. Enthesitis was assessed at weeks 0 and 24 (Maastricht Ankylosing Spondylitis Enthesitis Score). Assessments included Health Assessment Questionnaire–Disability Index (HAQ-DI), Medical Outcomes Study Short Form-36 (SF-36) physical component summary/mental component summary (PCS/MCS), and American College of Rheumatology 20 (ACR20).Results.At Week 24, 21 had worsened enthesitis, 158 had improved enthesitis, and 412 had unchanged enthesitis. Improved enthesitis was associated with improvements in HAQ-DI and SF-36 MCS. Results were similar for ACR20 responders and nonresponders.Conclusion.Improvement in enthesitis at Week 24 was associated with improvements in physical function/HRQOL regardless of ACR20 response.

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Macía-Villa, Cristina, Sandra Falcao, Marwin Gutierrez, Julio Medina, Hilde Berner Hammer, and Eugenio De Miguel. "Peritenon Extensor Tendon Inflammation in Psoriatic Arthritis Is an Enthesitis-related Lesion." Journal of Rheumatology 46, no. 10 (February 1, 2019): 1295–98. http://dx.doi.org/10.3899/jrheum.180856.

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Objective.To analyze the association between enthesitis, synovitis, and peritenon extensor tendon inflammation (PTI) in psoriatic arthritis (PsA).Methods.PsA patients with swelling of metacarpophalangeal joints were included. Greyscale and power Doppler (PD) were used for synovitis and PTI ultrasound identification. Madrid Sonographic Enthesis Index (MASEI) was used for enthesitis assessment. PD activity was evaluated using PD item of MASEI and PD Outcome Measures in Rheumatology (OMERACT) definition.Results.Synovitis had no association with enthesitis. PTI was associated with PD MASEI and PD OMERACT. Only PD OMERACT showed a positive correlation with PTI.Conclusion.In PsA, PTI is associated to enthesitis, as opposed to synovitis.

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Blackard, Michael F., Prapti A. Patel, Divya A. Pandya, Manish K. Gupta, and Abhijit S. Pandya. "A case of mistaken identity: an enthesitis-related arthritis case report." International Journal Of Community Medicine And Public Health 8, no. 5 (April 27, 2021): 2531. http://dx.doi.org/10.18203/2394-6040.ijcmph20211786.

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Juvenile idiopathic arthritis is the most common inflammatory rheumatological condition affecting children. The condition stems from the inability of the immune system to discriminate between self and not-self leading to inappropriate immune reactions against joints. The different subtypes are differentiated by the number of joints involved and the presence or absence of certain exclusion factors. Due to overlapping diagnostic criterion and range of clinical presentation, diagnosis can be a difficult task. Our patient initially presented with joint swelling without pain that was initially diagnosed with traumatic swelling that later was considered to be of an infectious etiology. A biopsy revealed synovitis but current treatment for traumatic and infectious causes continued to fail. Finally, an additional joint showed inflammation leading to additional testing that uncovered that the patient was positive for HLA-B27 as well as a first degree relative with ankylosing spondylitis. This coupled with the inflammatory biopsy findings led to the diagnosis of juvenile idiopathic arthritis. The identification of an HLA-B27 positive patient is important as this population has been shown to have low rates of remission, resistance to certain treatments used for juvenile idiopathic arthritis, specifically DMARDS and corticosteroids which are often first line treatments for juvenile idiopathic arthritis. The HLA-B27 patient population has also been shown to progress to axial involvement and joint destruction leading to earlier need for arthroplasties. As early identification is important in the determination to begin biologic treatments early in the disease course, physician should maintain a clinical suspicion for JIA when dealing with swollen joints in the pediatric population.

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EMAD, YASSER, YASSER RAGAB, IMAN BASSYOUNI, OMAR MOAWAYH, MAGDY FAWZY, AHMED SAAD, ALAA ABOU-ZEID, and JOHANNES J. RASKER. "Enthesitis and Related Changes in the Knees in Seronegative Spondyloarthropathies and Skin Psoriasis: Magnetic Resonance Imaging Case-Control Study." Journal of Rheumatology 37, no. 8 (June 15, 2010): 1709–17. http://dx.doi.org/10.3899/jrheum.100068.

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Objective.To describe enhanced magnetic resonance imaging (MRI) features and characteristic entheseal changes in the knees in patients with seronegative spondyloarthropathy (SpA).Methods.The 56 patients included 30 with psoriatic arthritis, 5 with ankylosing spondylitis, 5 with reactive arthritis, 5 with ulcerative colitis (UC), 5 with Crohn’s disease, and another 6 with skin psoriasis. Controls were 20 healthy subjects without knee complaints. MRI was performed in all participants, emphasizing entheseal sites.Results.Both knees were studied in 45 (80.3%) patients and one knee in 11 (19.6%). MRI showed evidence of bone marrow edema in 13 (23.2%) patients, cartilaginous erosions in 18 (32.1%), and bone erosions in 9 (16.1%). Enthesitis was found in medial collateral ligaments in 18 (32.1%), lateral collateral ligaments in 8 (14.3%), posterior cruciate ligaments in 3 (5.35%), patellar tendon in 18 (32.1%), biceps femoris insertion in 3 (5.35%), medial patellofemoral ligaments (MPFL) in 5 (8.9%), and lateral patellofemoral ligament in 1 patient (1.8%). In the UC and Crohn’s patients (n = 10), 2 had bone erosions and 5 had enthesitis. In the skin psoriasis group (n = 6), one had bone marrow edema; enthesitis was detected in 5 at the patellar tendon insertion and in one in the MPFL. Entheseal-related changes were absent in the controls.Conclusion.This is the first study showing entheseal-related changes in the knees in patients with inflammatory bowel disease or skin psoriasis without clinical arthritis. Enthesitis of the knee on MRI may be an early finding in SpA.

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Saxena, N., R. Misra, and A. Aggarwal. "Is the enthesitis-related arthritis subtype of juvenile idiopathic arthritis a form of chronic reactive arthritis?" Rheumatology 45, no. 9 (March 7, 2006): 1129–32. http://dx.doi.org/10.1093/rheumatology/kel056.

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MAHENDRA, ANKIT, RAMNATH MISRA, and AMITA AGGARWAL. "Th1 and Th17 Predominance in the Enthesitis-related Arthritis Form of Juvenile Idiopathic Arthritis." Journal of Rheumatology 36, no. 8 (June 16, 2009): 1730–36. http://dx.doi.org/10.3899/jrheum.081179.

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Objective.A Th1 biased immune response in synovial fluid has been reported in children with polyarticular and extended oligoarticular-type juvenile idiopathic arthritis (JIA). We investigated T cell phenotypes including Th1, Th2, Th17, and Treg with emphasis on Th17 and Treg, in order to differentiate cytokines in the enthesitis-related arthritis (ERA) form of JIA.Methods.The frequencies of Th1, Th2, Th17, and Treg cells were determined by flow cytometry in peripheral blood (PB) and synovial fluid from patients with ERA and healthy subjects. Levels of interleukin 1ß (IL-1ß), IL-6, IL-21, IL-23, and transforming growth factor ß (TGF-ß), cytokines that influence Th17 lineage cells, were measured in paired plasma and synovial fluid (SF) samples by ELISA. Frequencies are expressed as percentages and cytokine levels as pg/ml.Results.There were no differences in blood samples in the frequency of Th1, Th2, Th17, and Treg cells between patients and controls. In paired samples, the median frequency of CD4+IFN-γ+ (20.49 vs 4.03; p < 0.005) and CD4+IL-17+ (2.27 vs 0.57; p < 0.01) cells was significantly higher in SF compared to PB, respectively; whereas the frequency of CD4+IL-4+ (1.79 vs 2.29; p < 0.04) cells was significantly reduced in the SF compared to PB. There was no difference in the frequency of regulatory T cells. Patients receiving methotrexate had fewer Th2 cells, whereas the Childhood Health Assessment Questionnaire score had a negative association with the frequency of Treg. Median levels of IL-1ß (p < 0.008), IL-6 (p < 0.0001), and IL-17 (p < 0.0001) were higher in SF than in plasma and levels of TGF-ß were lower (p < 0.001). Levels of IL-21 were similar in SF and plasma, whereas IL-23 was undetectable.Conclusion.In patients with ERA, peripheral blood Th1, Th2, Th17, and Treg cells were unchanged, but Th1 and Th17 cells were increased and Th2 cells were reduced in the SF compared to blood. Elevated IL-1ß and IL-6 in SF may be responsible for increased Th17 cells.

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STOLL, MATTHEW L., MARILYNN PUNARO, and ASHISH S. PATEL. "Fecal Calprotectin in Children with the Enthesitis-related Arthritis Subtype of Juvenile Idiopathic Arthritis." Journal of Rheumatology 38, no. 10 (October 2011): 2274–75. http://dx.doi.org/10.3899/jrheum.110508.

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Gaur, P., A. Myles, R. Misra, and A. Aggarwal. "Intermediate monocytes are increased in enthesitis-related arthritis, a category of juvenile idiopathic arthritis." Clinical & Experimental Immunology 187, no. 2 (October 28, 2016): 234–41. http://dx.doi.org/10.1111/cei.12880.

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Singh, Yogesh Preet, and Amita Aggarwal. "O27 Disease phenotype in adults with enthesitis related arthritis subtype of juvenile idiopathic arthritis." Indian Journal of Rheumatology 5, no. 3 (November 2010): S9. http://dx.doi.org/10.1016/s0973-3698(10)60602-4.

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Aggarwal, Amita, R. Srivastava, S. Singh, and P. Kumar Dubey. "P56 IL-1 gene polymorphisms in enthesitis-related arthritis category of juvenile idiopathic arthritis." Indian Journal of Rheumatology 6, no. 3 (November 2011): S17. http://dx.doi.org/10.1016/s0973-3698(11)60166-0.

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Aggarwal, A., R. Srivastava, S. Singh, and P. Kumar Dubey. "IL1 gene polymorphisms in enthesitis related arthritis category of juvenile idiopathic arthritis (ERA-JIA)." Clinical Rheumatology 31, no. 4 (November 29, 2011): 607–11. http://dx.doi.org/10.1007/s10067-011-1898-8.

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Phatak, Sanat, Namita Mohindra, Abhishek Zanwar, and Amita Aggarwal. "Prominent midfoot involvement in children with enthesitis-related arthritis category of juvenile idiopathic arthritis." Clinical Rheumatology 36, no. 8 (June 20, 2017): 1737–45. http://dx.doi.org/10.1007/s10067-017-3733-3.

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Fairushina, I., D. Abdulganieva, E. Kirillova, and R. Abdrakipov. "SAT0415 AGE RELATIONSHIP WITH ULTRASOUND ARTICULAR AND ENTHESEAL INVOLVEMENT IN PSORIATIC ARTHRITIS: CROSS-SECTIONAL STUDY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1160.2–1161. http://dx.doi.org/10.1136/annrheumdis-2020-eular.5902.

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Background:Detection of subclinical enthesitis and synovitis in psoriatic arthritis (PsA) is prevalent and ultrasound (US) examination is informative tool for it diagnosing. Aging positively affects degenerative changes.Objectives:To study relationship between US articular and entheseal findings with age in patients with PsA.Methods:57 patients were enrolled to study with fulfilled PsA criteria (CASPAR, 2009). Data collection: demographical, clinical (current psoriasis, axial involvement, enthesitis, dactylitis), US (synovitis count (by Grey Scale), Power Doppler(PD)+ synovitis), thickening and hypoechogenicity at enthesis, PD+ enthesitis, entheses with structural components); biological (high sensitive C-reactive protein (hsCRP), Erythrocyte Sedimentation Rate (ESR).US examination included 798 joints and 3078 entheses (bilateral shoulders, acromioclavicular joints, elbows, wrists, hips, knees, ankles; entheses at the projection of these joints (total number - 54). US entheseal findings were fixed according to consensus-based US definition and scoring for enthesitis in spondyloarthritis and PsA (OMERACT US)1.Results:In all 57 patients: male - 25 (43.9%), mean age 43.4±10.3(SD) years (y), PsA duration was 7 (3;10) y, Ps duration 10 (8; 22) y; 53 (41.1%) had axial involvement, 42 (73.7%) dactylitis, 8 (14%) clinical enthesitis, and 56 (98.2 %) skin psoriasis, Psoriasis Activity and Severity Index score 6.4 (2;14.4), Disease Activity in PsA score 18.1 (10.2;26.1), hsCRP 10.1(2.4;21.4), ESR 20 (11.3;31.5).Synovitis count increased with age noticeably (r=0.508, p<0.01), and weak correlation of PD+ synovitis (r=0.262, p=0.049) and age was found. The entheseal thickening and hypoechogenicity and structural findings increased with age respectively (r=0.345, p=0.009; r=0.337, p=0.01). There was no correlation between PD+ enthesitis and age. The assosiation between PD+ enthesitis and blood biomarkers of inflammation (hs-CRP (r=0.364, p=0.008); ESR (p=0.358, p=0.008) was found.Conclusion:Our study found significant relationship between age and US synovitis. Association between age and US entheseal involvement was noted. Only PD+ enthesitis was not related with age in comparison with other US entheseal findings. The presence of PD US signal at enthesitis in association with increased inflammatory blood biomarkers can be evaluated as the sign of disease activity regardless of age and not as age-related lesion in PsA patients.References:[1]Balint PV, Terslev L, Aegerter P et al. Reliability of a consensus-based ultrasound definition and scoring for enthesitis in spondyloarthritis and psoriatic arthritis: an OMERACT US initiative. Ann Rheum Dis.;2018;77(12):1730-1735.Disclosure of Interests:None declared

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KS, Dr Sreeja, and Dr Jagannatha Sahoo. "Enthesitis related arthritis: A case report of delayed diagnosis and management." International Journal of Orthopaedics Sciences 6, no. 4 (October 1, 2020): 33–35. http://dx.doi.org/10.22271/ortho.2020.v6.i4a.2316.

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Ferjani Hanene, Lassoued, Lobna Ben Ammar, Kaouther Maatallah, Dorra Ben Nessib, Wafa Triki, Dhia Kaffel, and Wafa Hamdi. "Enthesitis-related arthritis and spondylarthritis: the same disease or disparate entities?" Expert Review of Clinical Immunology 18, no. 1 (December 1, 2021): 93–99. http://dx.doi.org/10.1080/1744666x.2022.2010547.

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Horneff, Gerd. "Tumour necrosis factor inhibitors in enthesitis related arthritis and juvenile spondylarthropathies." Expert Opinion on Orphan Drugs 6, no. 2 (February 2018): 127–40. http://dx.doi.org/10.1080/21678707.2018.1433032.

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Zhelezova, Veronika, Martin Boyadzhiev, and Boryana Varbanova. "Clinical aspects of HLA-B27 positive enthesitis-related arthritis in childhood." Scripta Scientifica Medica 54, no. 2 (March 18, 2022): 9. http://dx.doi.org/10.14748/ssm.v0i0.8016.

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Tan, Ai Lyn, Eiji Fukuba, Nicola Ann Halliday, Steven F. Tanner, Paul Emery, and Dennis McGonagle. "High-resolution MRI assessment of dactylitis in psoriatic arthritis shows flexor tendon pulley and sheath-related enthesitis." Annals of the Rheumatic Diseases 74, no. 1 (September 26, 2014): 185–89. http://dx.doi.org/10.1136/annrheumdis-2014-205839.

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ObjectiveDactylitis is a hallmark of psoriatic arthritis (PsA) where flexor tenosynovitis is common. This study explored the microanatomical basis of dactylitis using high-resolution MRI (hrMRI) to visualise the small entheses around the digits.MethodsTwelve patients with psoriatic dactylitis (4 fingers, 8 toes), and 10 healthy volunteers (6 fingers, 4 toes) had hrMRI of the digits using a ‘microscopy’ coil and contrast enhancement. All structures were evaluated including the tendons and ligaments, related enthesis organs, pulleys, volar/plantar plates and tendon sheaths.ResultsIn dactylitis, collateral ligament enthesitis was seen in nine digits (75%), extensor tendon enthesitis in six digits (50%), functional enthesitis (5 digits, 42%), abnormal enhancement at the volar plates (2/5 joints, 40%) and the plantar plate (1/5 joints, 20%). Nine cases (75%) demonstrated flexor tenosynovitis, with flexor tendon pulley/flexor sheath microenthesopathy observed in 50% of all cases. Less abnormalities which were milder was observed in the normal controls, none of whom had any signal changes in the tendon pulleys or fibrous sheaths.ConclusionsThis study provides proof of concept for a link between dactylitis and ‘digital polyenthesitis’ including disease of the miniature enthesis pulleys of the flexor tendons, further affirming the concept of enthesitis in PsA.

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WEISS, PAMELA F., TIMOTHY BEUKELMAN, LAURA E. SCHANBERG, YUKIKO KIMURA, and ROBERT A. COLBERT. "Enthesitis-related Arthritis Is Associated with Higher Pain Intensity and Poorer Health Status in Comparison with Other Categories of Juvenile Idiopathic Arthritis: The Childhood Arthritis and Rheumatology Research Alliance Registry." Journal of Rheumatology 39, no. 12 (October 15, 2012): 2341–51. http://dx.doi.org/10.3899/jrheum.120642.

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Objective.To assess the relative effect of clinical factors and medications on pain intensity, physical function, and health status in juvenile idiopathic arthritis (JIA).Methods.We conducted a retrospective cross-sectional study of data from children with JIA enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry. We tested whether clinical characteristics of JIA were associated with pain intensity, physical function, and health status using multivariable linear and ordinal logistic regression.Results.During the study period, 2571 subjects with JIA enrolled in the CARRA Registry. Ratings of pain intensity, physical function, and health status differed significantly between JIA categories. In comparison to other categories of JIA, subjects with enthesitis-related arthritis (ERA) reported worse pain and function. In multivariable analyses, higher active joint count and current use of nonsteroidal antiinflammatory drugs (NSAID), biologics, or corticosteroids were associated with worse scores on all patient-reported measures. ERA and older age were significantly associated with higher pain intensity and poorer health status. Systemic JIA and uveitis were significantly associated with worse health status. Enthesitis, sacroiliac tenderness, and NSAID use were independently associated with increased pain intensity in ERA. The correlation was low between physician global assessment of disease activity and patient-reported pain intensity, physical function, and health status.Conclusion.Significant differences in pain intensity, physical function, and health status exist among JIA categories. These results suggest that current treatments may not be equally effective for particular disease characteristics more common in specific JIA categories, such as enthesitis or sacroiliac tenderness in ERA.

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Felbo, Sara, Mikkel Østergaard, Inge Sørensen, and Lene Terslev. "Ultrasound of the Heel Improves Diagnosis—Tender Entheses in the Heel Region Rarely Corresponds to Inflammatory Enthesitis in Patients with Peripheral Spondyloarthritis." Journal of Clinical Medicine 11, no. 9 (April 21, 2022): 2325. http://dx.doi.org/10.3390/jcm11092325.

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Enthesitis is a key pathology in spondyloarthritis (SpA), but diagnosis may be clinically challenging. The objective of this study was to investigate the prevalence of ultrasound enthesitis lesions in tender entheses in the heel region in patients with peripheral SpA. In 27 patients with tenderness upon palpation at the Achilles tendon or the plantar fascia insertion, ultrasound assessment of the affected enthesis was performed using greyscale and color Doppler mode. Images were evaluated using the Outcome Measures in Rheumatology (OMERACT) scoring system for enthesitis, scoring presence/absence of hypoechogenicity, thickening, calcifications/enthesophytes, and erosions, and color Doppler activity semi quantitatively from 0 to 3. A total enthesitis sum score was calculated. A second examiner scanned 10 patients for inter-reader reliability. Ultrasound signs of inflammatory enthesitis (thickening/hypoechogenicity and/or Doppler activity) were found in 48%, and 19% showed Doppler activity—all in the Achilles enthesis. Inflammatory pathologies other than enthesitis (e.g., tendinitis, arthritis, bursitis) were identified in 26% of tender heels. The ultrasound OMERACT scoring system for enthesitis lesions showed excellent intra- and inter-reader agreement in a clinical setting. In conclusion, less than 50% of clinically tender entheses are related to inflammatory enthesitis when assessed by ultrasound. Ultrasound is useful for diagnosing other pathologies that may explain tenderness in the area.

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Makay, Balahan, Özge Altuğ Gücenmez, and Erbil Ünsal. "Inactive Disease in Enthesitis-related Arthritis: Association of Increased Body Mass Index." Journal of Rheumatology 43, no. 5 (March 15, 2016): 937–43. http://dx.doi.org/10.3899/jrheum.151208.

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Objective.Patients with enthesitis-related arthritis (ERA) were less likely to achieve and sustain inactive disease than children with other subtypes of juvenile idiopathic arthritis. The aim of this study was to evaluate the effect of increased body mass index (BMI) on clinical features of the disease and to investigate whether being overweight or obese limits the possibility of achieving clinically inactive disease in patients with ERA.Methods.The hospital charts of 72 patients with ERA were reviewed. Demographic and clinical findings were recorded. Patients were divided into 2 groups according to whether they had “healthy weight” (BMI < 85th percentile) or “increased weight” (BMI ≥ 85th percentile) at baseline. The primary outcome of this study was to achieve inactive disease at 1 year after the initiation of therapy. The inactive disease criterion of Wallace,et alwas used to define inactive disease status.Results.Twenty patients had increased BMI. The frequency of tarsitis and ankle involvement was higher in patients with increased weight. Thirty-seven patients were inactive at the end of 1 year. In univariate analyses, male sex, increased BMI, ankle involvement, and tarsitis were found to be associated with failure to achieve inactive disease. Multivariate backward stepwise regression analyses revealed that failure to achieve clinically inactive disease was associated with increased BMI and ankle involvement.Conclusion.Being overweight or obese was associated with failure to achieve inactive disease in patients with ERA. Because body weight is a modifiable factor, individualized interventions may have clinical implications for better therapeutic outcome.

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Fisher, C., J. Ioannou, D. Sen, I. Goff, E. Coulson, and H. Foster. "Paediatric and adolescent rheumatology: 126. Enthesitis-Related Arthritis: Two Distinct Clinical Phenotypes?" Rheumatology 50, Supplement 3 (March 30, 2011): iii90—iii91. http://dx.doi.org/10.1093/rheumatology/ker158.

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Fisher, Corinne, Linda Suffield, Anna Radziszewska, Debajit Sen, and Yiannis Ioannou. "OP4. Enthesitis-related arthritis in adolescence: disease phenotype in a large cohort." Rheumatology 54, suppl_2 (May 2015): ii3—ii4. http://dx.doi.org/10.1093/rheumatology/keu493.

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Genuis, Stephen J., and Anna-Kristen J. Siy. "Nutritional supplementation and dietary restriction in the resolution of enthesitis-related arthritis." JRSM Short Reports 2, no. 4 (April 2011): 1–7. http://dx.doi.org/10.1258/shorts.2011.011012.

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Mannion, Melissa L., Linda McAllister, Randy Q. Cron, and Matthew L. Stoll. "Ustekinumab as a Therapeutic Option for Children With Refractory Enthesitis-Related Arthritis." JCR: Journal of Clinical Rheumatology 22, no. 5 (August 2016): 282–84. http://dx.doi.org/10.1097/rhu.0000000000000408.

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Sarma, Pradip, Ramnath Misra, and Amita Aggarwal. "Outcome in patients with enthesitis related arthritis (ERA): juvenile arthritis damage index (JADI) and functional status." Pediatric Rheumatology 6, no. 1 (2008): 18. http://dx.doi.org/10.1186/1546-0096-6-18.

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Saravanan, Mayilsamy, Chinnadurai Saranya, Mantharam Vignesh, Vengudusamy Sivakumar, Annamalai Sowndhariya, and Seetharaman Mythili. "STUDY ON CLINICAL PROFILE, OUTCOME AND HLA-B27 ASSOCIATION IN JUVENILE IDIOPATHIC ARTHRITIS- ENTHESITIS RELATED ARTHRITIS." Journal of Evolution of Medical and Dental Sciences 6, no. 77 (September 25, 2017): 5509–12. http://dx.doi.org/10.14260/jemds/2017/1196.

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Journal articles on the topic 'Enthesitis-related arthritis'

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