Clinical indices used in the assessment of enthesitis.
| Index Name/Scoring System | Originally Devised for | No. Sites Examined | Sites Examined | Features | Imaging Modality |
|---|---|---|---|---|---|
| Leeds Enthesitis Index (LEI)* 2,11 | PsA | 6 | Bilateral lateral epicondyles, medial femoral condyles, and Achilles tendon insertions | Only index specifically developed for PsA; has been used in several PsA trials – developed by clinical identification of the most frequent enthesitis sites Physical examination measuring tenderness as either present (1) or absent (0) at each site, resulting in an overall score of 0–6 Higher count indicates greater enthesitis burdenMost reliable index for PsA; correlates most closely withdisease activity compared with MASES and SPARCC | None |
| Spondyloarthritis Research Consortium of Canada (SPARCC) index*2,11 | SpA | 16 | Bilateral Achilles tendons, plantar fascia insertion at the calcaneus, patellar tendon insertion at the base of the patella, quadriceps insertion into the superior border of the patella, supraspinatus insertion into the greater tuberosity of the humerus, and medial and lateral epicondyles | Assessment sites based on power Doppler US in SpA and MRI studies in AS. Most common sites for enthesitis were identified Physical examination measuring tenderness as either present (1) or absent (0) at each site, resulting in an overall score of 0–16 Higher count indicates greater enthesitis burden Modified versions measuring 6–8 more commonly involved sites have shown greater responsiveness Not validated for use in PsA, although has been tested in this patient population | None |
| The Maastricht Ankylosing Spondylitis Enthesis Score (MASES)*2,11,12 | AS | 13 | First costochondral joints, seventh costochondral joints, posterior and anterior superior iliac spines, iliac crests, proximal insertion of Achilles tendons, fifth lumbar spinous process (does not assess many of the peripheral sites characteristic of PsA) | Developed from the Mander/Newcastle Enthesitis Index (most comprehensive index for AS, with 66 clinically accessible enthesis sites) Most specific and sensitive sites were selected to reduce assessment time Physical examination measuring tenderness as either present (1) or absent (0) at each site, resulting in an overall score of 0–13 Higher count indicates greater enthesitis burden Not validated for use in PsA, although a PsA-modified version has been developed | None |
↵* LEI, MASES, and SPARCC have all been used in trials of PsA2.