{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T01:33:19Z","timestamp":1782783199624,"version":"3.54.5"},"reference-count":34,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T00:00:00Z","timestamp":1605225600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005205","name":"Janssen Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005205","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016036","name":"Health~Holland","doi-asserted-by":"crossref","award":["LSHM16011"],"award-info":[{"award-number":["LSHM16011"]}],"id":[{"id":"10.13039\/100016036","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2020,11,11]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec id=\"s1\">\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To compare the Heel Enthesitis MRI Scoring model (HEMRIS) with clinical and PET\/CT outcomes in patients with cutaneous psoriasis (Pso), psoriatic arthritis (PsA) or ankylosing spondylitis (AS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s2\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This prospective, observational study included 38 patients with Pso, PsA and AS. Patients were included regardless of presence or absence of clinical heel enthesitis. MRI-scans of both ankles and a whole-body <jats:sup>18<\/jats:sup>F-FDG PET\/CT were acquired. MRIs were assessed for enthesitis by two independent and blinded observers according to the HEMRIS. A physician, blinded for imaging results, performed clinical evaluations of enthesitis at the Achilles tendon and plantar fascia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s3\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 146 entheses were scored according to the HEMRIS and clinically assessed for enthesitis (6 entheses were clinically affected). In Achilles tendons with clinical enthesitis, the HEMRIS structural damage score was significantly higher, compared to Achilles tendons without clinical enthesitis (respective median scores 1.0 and 0.5; p=0.04). In clinically unaffected entheses, HEMRIS abnormalities occurred in 44\/70 (63%) of Achilles tendons and in 23\/70 (33%) of plantar fascia. At the Achilles tendon, local metabolic activity measured on PET\/CT was weakly associated with the structural (r<jats:sub>s<\/jats:sub>=0.25, p=0.03) and total HEMRIS (r<jats:sub>s<\/jats:sub>=0.26, p=0.03).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s4\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study revealed a high prevalence of subclinical HEMRIS abnormalities and discrepancy between HEMRIS and clinical and PET\/CT findings. This may suggest that the HEMRIS is a sensitive method for detection of inflammatory and structural disease of enthesitis at the Achilles tendon and plantar fascia, although the clinical significance of these MRI findings remains to be determined in longitudinal studies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2020-001424","type":"journal-article","created":{"date-parts":[[2020,12,4]],"date-time":"2020-12-04T05:30:40Z","timestamp":1607059840000},"page":"e001424","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Comparison of the Heel Enthesitis MRI Scoring System (HEMRIS) with clinical enthesitis and local metabolic activity on PET-CT"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4010-6179","authenticated-orcid":false,"given":"Nienke J","family":"Kleinrensink","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, UMC Utrecht, Utrecht, Netherlands"},{"name":"Department of Radiology, UMC Utrecht, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4970-8555","authenticated-orcid":false,"given":"Wouter","family":"Foppen","sequence":"additional","affiliation":[{"name":"Department of Radiology, UMC Utrecht, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Ten Katen","sequence":"additional","affiliation":[{"name":"Department of Radiology, UMC Utrecht, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieternella H","family":"van der Veen","sequence":"additional","affiliation":[{"name":"Department of Radiology, UMC Utrecht, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"de Klerk","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, UMC Utrecht, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne C E","family":"Diepstraten","sequence":"additional","affiliation":[{"name":"Department of Radiology, UMC Utrecht, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R D J","family":"Radstake","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, UMC Utrecht, Utrecht, Netherlands"},{"name":"Center for Translational Immunology, UMC Utrecht, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floris P J G","family":"Lafeber","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, UMC Utrecht, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim A","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Radiology, UMC Utrecht, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmerik F A","family":"Leijten","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, UMC Utrecht, Utrecht, Netherlands"},{"name":"Center for Translational Immunology, UMC Utrecht, Utrecht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,12,3]]},"reference":[{"key":"2025090312104802000_6.3.e001424.1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.181093"},{"key":"2025090312104802000_6.3.e001424.2","doi-asserted-by":"publisher","DOI":"10.1002\/art.21972"},{"key":"2025090312104802000_6.3.e001424.3","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.108233"},{"key":"2025090312104802000_6.3.e001424.4","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1002\/art.39573","article-title":"Group for research and assessment of psoriasis and psoriatic arthritis 2015 treatment 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