| Name of the Instrument/Tool | Leeds Enthesitis Index (LEI) |
| First Description |
Healy PJ, Helliwell PS. Measuring clinical enthesitis in psoriatic arthritis: assessment of existing measures and development of an instrument specific to psoriatic arthritis. Arthritis Rheum 2008;59:686–91. |
| Year | 2008 |
| Domains | |
| Concept of constructs | Disease activity |
| Population/Disease | Disease specific |
| Originally developed for | Psoriatic Arthritis (PsA) |
| Other rheumatic diseases where can be applied (only if validated) |
Spondyloarthritis |
| Additional population with no rheumatic diseases |
No |
| Language: Originally published in | English |
| Available in Language | English |
| REFERENCE IDENTIFICATION | |
| Author/s | Healy PJ, Helliwell PS |
| Title | Measuring clinical enthesitis in psoriatic arthritis: assessment of existing measures and development of an instrument specific to psoriatic arthritis |
| Journal | Arthritis Rheum |
| Year | 2008 |
| Vol | --- |
| Num | 59 |
| Pages | 686-91 |
| Country | United Kingdom |
| Language | English |
| Other references of interest | |
| Link | https://pubmed.ncbi.nlm.nih.gov/17659754/ |
| Brief Description |
International spondyloarthritis interobserver reliabilaity exercise: the INSPIRE study. II. Assessment of peripheral joints, enthesitis, and dactylitis. |
| Link | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5115257/ |
| Brief Description |
Assessment of enthesitis in patients with psoriatic arthritis using clinical examination and ultrasound. |
| Link | https://pubmed.ncbi.nlm.nih.gov/33091263/ |
| Brief Description |
Measuring Outcomes in Psoriatic Arthritis |
| Instrument/Tool Translations References | |
| No other References. | |
| DEVELOPER CONTACT INFORMATION | |
| Correspondence to | Paul Healy |
| paul.healy@huttvalleydhb.org.nz | |
| Address | Wellington Regional Rheumatology Unit, Hutt Valley District Health Board, Lower Hutt, New Zealand. |
| Website | --- |
| Available | --- |
| Links | --- |
| DESCRIPTION OF THE INSTRUMENT | |
| Type Of Measure | Composite Index |
| Brief Description |
The Leeds enthesitis index (LEI) was specifically developed for PsA (unlike the others, which were developed for AS). The final sites were identified based on a stepwise data reduction technique. Similar to the joint count, approximately 4 kg/cm2 of pressure is applied to the areas of interest, and the total number of regions in which the patient ascribes to tenderness is counted. The LEI is performed as a part of the physical examination, and scores may be captured on a simple scoring sheet (paper or electronic). |
| Number of Items | It consists of 6 sites: bilateral Achilles tendon insertions, medial femoral condyles, and lateral epicondyles of the humerus. |
| Range | 0-6 |
| Responses options/scale |
No |
| Developed for | Research, Clinical practice |
| PRACTICAL APPLICATION | |
| Method of administration | Physician |
| Recommendations to score |
The score is the sum of sites counted as tender (each site is a binary assessment of tender (1) or not tender (0)). |
| Score Interpretation | Higher scores indicate more sites with enthesitis |
| Cut-off points | --- |
| Cut-off points applied to | --- |
| Smallest detectable change if described | --- |
| Smallest detectable change applied to | --- |
| Completion time by the patient | 1 minutes |
| Scoring time by the assessor | 1 minutes |
| Training to score | Not necessary |
| Strengths | Useful in clinical practice & research, Easy to use |
| Limitations | --- |
| OTHER COMMENTS | |
| Other Comments |
The LEI has been used in several trials now and has demonstrated responsiveness and clinical trial discrimination. |