Are there circumstances when you may consider imaging enthesitis in patients with psoriatic arthritis?

If you already know that there is "enthesitis", then there may not be a reason for imaging. However, there are a few circumstances to consider imaging entheses in a patient with psoriatic arthritis:

1) When there is concomitant widespread pain syndrome and the enthesis is tender but not swollen on physical examination - ultrasound or MRI can confirm objective abnormality with a high degree of sensitivity, and help determine whether to attribute the tenderness to disease activity.

• Fiorenza et al.,...

Enthesitis is in the eye of the beholder: so many patients I pick up have plantar fasciitis and hla b27 pos. When I ask what was going on in life it's always: I was a waitress working two jobs, I picked up running, etc. This is a wonderful answer above but enthesitis begins with a ROS for MSK, overuse versus true inflam tendon: tendon sporadic intermittent flares at normal activity level versus I have golfer's elbow but oh, by the way, I picked up golf, or I am golfing more these days. Similar t...