Table of Contents
ISRN Rheumatology
Volume 2011, Article ID 731917, 5 pages
Clinical Study

Clinical and Ultrasound Examination of the Leeds Enthesitis Index in Psoriatic Arthritis and Rheumatoid Arthritis

1St. Luke’s Hospital, Bradford Teaching NHS Foundation Trust, Bradford BD5 0NA, UK
2Rheumatology Unit, Central Military Hospital, Bogotá, Colombia
3Rheumatology Unit, Central Police Hospital, Bogotá, Colombia
4Department of Rheumatology, Hutt Hospital, Lower Hutt, Wellington 5011, New Zealand
5Academic Unit of Musculoskeletal Disease, University of Leeds, Leeds LS7 4SA, UK

Received 26 January 2011; Accepted 7 March 2011

Academic Editors: G. E. Caughey and E. R. Soriano

Copyright © 2011 G. Ibrahim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To compare scores for the Leeds enthesitis index in psoriatic arthritis and rheumatoid arthritis using clinical assessment and ultrasonography (US). Design. Swelling and tenderness of the enthesis was assessed at six sites: lateral epicondyles of humerus (LE), medial condyles of femur (MC), and the insertion of the Achilles tendon (AT). US assessed “inflammatory activity” (power Doppler signal, oedema, tendon thickening, and bursal swelling) and “damage” (erosions and enthesophytes). Results. 94 patients were included, 71 with PsA and 23 with RA. The patients with RA were significantly older (PsA 47.6 years; RA 62.6 years; (mean difference in ages =15.0 years, 95% CI 9.3–20.7 years)). US scores were higher in RA at the LE, significantly so for the “damage” scores. No differences between RA and PsA were seen at the other sites. As a result, the odds ratio for PsA, given an US score above the median, was 0.41 (0.13–1.03). However, using the clinical score, the odds ratio for PsA was 2.16 (0.81–5.70). Conclusions. Although clinical scores of enthesitis are greater in PsA compared to RA, US enthesitis scores did not distinguish between RA and PsA. This may in part be due to more frequent juxta-articular involvement in RA and in part due to the older age of the subjects with RA.