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Matters arising
Ultrasound detection of knee patellar enthesitis
  1. R J Wakefield,
  2. D McGonagle,
  3. A L Tan,
  4. A Evangelisto,
  5. P Emery
  1. Academic Department of Musculoskeletal Medicine, First Floor, Old Nurse’s Home, General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK
  1. Correspondence to:
    Professor P Emery
    p.emeryleeds.ac.uk

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    We read with interest the report by Kamel et al who highlighted the use of ultrasound (US) and magnetic resonance imaging (MRI) for the detection of patellar tendon enthesitis in patients with seronegative arthropathies without typical radiographic evidence.1 Their work adds to the growing body of evidence supporting the clinical use of US in rheumatological practice. US has previously been shown to be better than clinical examination for the detection of enthesitis,2,3 but data on MRI are more limited. The authors make interesting observations about the position of the abnormalities in the patellar tendon, when compared with the Achilles tendon, possibly relating to joint biomechanics and lines of force. However, we would like to raise a few points on what we regard as important omissions from the paper.

    Firstly, the authors do not include the frequencies of the described US or the technical details of the MRI findings and do not state how the modalities correlated with each other. The authors also do not comment on the presence of bone marrow oedema adjacent to the enthesis on MRI. With regard to the plantar fascia, …

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