title: Comparison of Clinical Examination versus Whole-body Magnetic Resonance Imaging of Enthesitis in Patients with Early Axial Spondyloarthritis during 3 Years of Continuous Etanercept Treatment.
abstract: OBJECTIVE
  To compare clinical examination versus whole-body magnetic resonance imaging (WB-MRI) of enthesitis in patients with early axial spondyloarthritis during 3 years of continuous etanercept (ETN) treatment.
  
  
  METHODS
  Forty-one patients underwent clinical and WB-MRI examinations for enthesitis at baseline and after 2 and 3 years of treatment. Twenty-one sites were assessed in 4 anatomic regions - anterior chest wall, pelvis, knee, and foot.
  
  
  RESULTS
  Clinical examination at baseline detected enthesitis in 57% of the patients (85 lesions, mean 2.1 lesions, SD 2.9), most of them in the pelvis (42 lesions in 17 patients) and anterior chest wall (19 lesions in 10 patients). The proportion of patients with clinically detected enthesitis decreased to 19% at Year 2 (mean 0.5, SD 1.5) and 14% at Year 3 (mean 0.7, SD 1.8). WB-MRI detected enthesitis at baseline in 21% of patients (22 lesions, mean 0.5 lesions, SD 1.1), also most frequently in the pelvis (12 lesions) and anterior chest wall (7 lesions). MRI-positive enthesitis decreased to 13% at Year 2 (mean 0.2 lesions, SD 0.5) and 14% at Year 3 (mean 0.2 lesions, SD 0.5). There was positive correlation of clinical and MRI findings at baseline at the anterior chest wall (p = 0.001) and the pelvis (p = 0.0001). No correlation was found at the knee and foot at baseline and for all regions at followup.
  
  
  CONCLUSIONS
  Both clinical examination and WB-MRI show a decrease in enthesitis after 2 and 3 years of ETN treatment, but correlation was limited to the pelvis and anterior chest wall at baseline.
authors.affiliation: From the Department of Radiology, Charité Medical University, Campus Mitte; Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; German Rheumatism Research Center, Berlin, Germany.C.E. Althoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; J. Sieper, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; I.H. Song, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; A. Weiß, MSc, German Rheumatism Research Center; T. Diekhoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; H. Haibel, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; B. Hamm, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte; K.G. Hermann, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte.
authors.forename: Christian E
authors.initials: CE
authors.lastname: Althoff
authors.affiliation: From the Department of Radiology, Charité Medical University, Campus Mitte; Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; German Rheumatism Research Center, Berlin, Germany.C.E. Althoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; J. Sieper, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; I.H. Song, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; A. Weiß, MSc, German Rheumatism Research Center; T. Diekhoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; H. Haibel, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; B. Hamm, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte; K.G. Hermann, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte.
authors.forename: Joachim
authors.initials: J
authors.lastname: Sieper
authors.affiliation: From the Department of Radiology, Charité Medical University, Campus Mitte; Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; German Rheumatism Research Center, Berlin, Germany.C.E. Althoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; J. Sieper, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; I.H. Song, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; A. Weiß, MSc, German Rheumatism Research Center; T. Diekhoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; H. Haibel, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; B. Hamm, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte; K.G. Hermann, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Song
authors.affiliation: From the Department of Radiology, Charité Medical University, Campus Mitte; Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; German Rheumatism Research Center, Berlin, Germany.C.E. Althoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; J. Sieper, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; I.H. Song, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; A. Weiß, MSc, German Rheumatism Research Center; T. Diekhoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; H. Haibel, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; B. Hamm, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte; K.G. Hermann, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte.
authors.forename: Anja
authors.initials: A
authors.lastname: Weiß
authors.affiliation: From the Department of Radiology, Charité Medical University, Campus Mitte; Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; German Rheumatism Research Center, Berlin, Germany.C.E. Althoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; J. Sieper, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; I.H. Song, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; A. Weiß, MSc, German Rheumatism Research Center; T. Diekhoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; H. Haibel, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; B. Hamm, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte; K.G. Hermann, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte.
authors.forename: Torsten
authors.initials: T
authors.lastname: Diekhoff
authors.affiliation: From the Department of Radiology, Charité Medical University, Campus Mitte; Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; German Rheumatism Research Center, Berlin, Germany.C.E. Althoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; J. Sieper, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; I.H. Song, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; A. Weiß, MSc, German Rheumatism Research Center; T. Diekhoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; H. Haibel, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; B. Hamm, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte; K.G. Hermann, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte.
authors.forename: Hildrun
authors.initials: H
authors.lastname: Haibel
authors.affiliation: From the Department of Radiology, Charité Medical University, Campus Mitte; Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; German Rheumatism Research Center, Berlin, Germany.C.E. Althoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; J. Sieper, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; I.H. Song, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; A. Weiß, MSc, German Rheumatism Research Center; T. Diekhoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; H. Haibel, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; B. Hamm, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte; K.G. Hermann, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.affiliation: From the Department of Radiology, Charité Medical University, Campus Mitte; Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; German Rheumatism Research Center, Berlin, Germany.C.E. Althoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; J. Sieper, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; I.H. Song, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; A. Weiß, MSc, German Rheumatism Research Center; T. Diekhoff, MD, Department of Radiology, Charité Medical University, Campus Mitte; H. Haibel, MD, PhD, Department of Rheumatology, Charité Medical University, Campus Benjamin Franklin; B. Hamm, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte; K.G. Hermann, MD, PhD, Department of Radiology, Charité Medical University, Campus Mitte. kghermann@gmail.com.
authors.forename: Kay-Geert A
authors.initials: KG
authors.lastname: Hermann
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D018450:Disease Progression; D000068800:Etanercept / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010808:Physical Examination; D025241:Spondylarthritis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D063189:Symptom Assessment; D016896:Treatment Outcome; D051598:Whole Body Imaging / Q000379:methods*; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D000068800:Etanercept
keywords: CLINICAL TRIAL; ENTHESITIS; MAGNETIC RESONANCE IMAGING; SPONDYLOARTHRITIS; TNF-α BLOCKER; WHOLE-BODY MRI