A clinical practice guideline for the screening and assessment of enthesitis in patients with spondyloarthritis

作者：Xinyu Wu, Dong Liu, Yanfei Li, Ya Xie, Liudan Tu, Yanli Zhang, Xi Zhang, Linkai Fang, Xiqing Luo, Zhiming Lin, Zetao Liao, Limin Rong, Jie Ren, Yuqi Zhou, Niansheng Yang, Jian Xu, Hua Zhang, Baijie Xu, Zhenbiao Wu, Feng Zhan, Zhenbin Li, Weiguo Xiao, Shengyun Liu, Yi Zhou, Shanhui Ye, Qing Lv, Lijun Zhang, Dongbao Zhao, Shanzhi He, Like Zhao, Lijun Wu, Lin He, Yunxiao Zhu, Donggeng Guo, Zehong Yang, Budian Liu, Kehu Yang, Jieruo Gu · 发表于：Frontiers in Immunology · 年份：2022 · DOI：10.3389/fimmu.2022.978504 · 被引用次数：13 · 研究领域：Spondyloarthritis Studies and Treatments、Rheumatoid Arthritis Research and Therapies、Scoliosis diagnosis and treatment

Objective: The aim of this review is to provide guidance on the selection of approaches to the screening and assessment of enthesitis in patients with spondyloarthritis (SpA). Methods: Twenty-four questions regarding the approaches to the screening and assessment of enthesitis and the implementation details were devised, followed by a systemic literature review. The Grading of Recommendations Assessment, Development, and Evaluation methodology was employed in the development of this guideline, with modifications to evaluate non-interventional approaches under comprehensive consideration of costs, accessibility, and evidence strength. A consensus from the voting panel was required for the inclusion of the final recommendations and the strength of each recommendation. Results: Seventeen recommendations (including five strong recommendations) were included in this guideline. The voting panel expressed unequivocal support for the necessity of screening and assessment of enthesitis in patients with SpA. It was agreed unanimously that symptom evaluation and physical examination should serve as the initial steps to the recognition of enthesitis, whereas Maastricht Ankylosing Spondylitis Enthesitis Score is a reliable tool in both clinical trials and daily medical practice. Ultrasound examination is another reliable tool, with power Doppler ultrasound as an informative addition. Notwithstanding its high resolution, MRI is limited by the costs and relatively low accessibility, whereas...