Objective To explore the MRI findings of enthesitis in peripheral ankylosing spondylitis (AS). Methods We retrospectively reviewed the MRI obtained from 13 patients with clinically-diagnosed peripheral AS. MRI finding attributable to enthesitis could be visualized as tendon or ligament enthesitis, bone marrow edema (BME), synovitis, bursitis, tenosynovitis. Results MRI findings of knee showed enthesitis in 8 knees, mainly involved in the insertions of the quadriceps tendon at the upper patellar pole , the patellar ligament at the lower patellar pole and the tibial tubercle, BME in 8 knees, synovitis in 5 knees, bursitis in 3 knees, and tenosynovitis in 4 knees. MRI findings of ankle showed enthesitis in 3 ankles, involved in plantar insertion into calcaneus and Achilles tendon insertion into the calcaneus, BME in 1 ankle, and tenosynovitis in 3 ankles. Conclusion The lower extremities are more often involved in peripheral AS than the upper extremities. MRI characteristic of enthesitis may contribute to the diagnosis of peripheral AS early combined with HLA-B27.%目的：探讨外周型强直性脊柱炎的MRI表现。方法：收集我院经临床确诊为外周型强直性脊柱炎13例患者的MRI图像行回顾性分析，将MRI表现分为肌腱或韧带附着点炎、骨髓水肿、滑膜炎、滑囊炎、腱鞘炎五种。结果：膝关节MRI表现：附着点炎8膝，主要位于髌韧带髌骨附着点、髌韧带胫骨附着点、股四头肌肌腱髌骨端附着点；骨髓水肿8膝；滑膜炎5膝；滑囊炎3膝；腱鞘炎4膝。踝关节MRI表现：附着点炎3踝，位于足底筋膜跟骨附着点、跟腱跟骨附着点；骨髓水肿1踝；腱鞘炎4踝。结论：外周型强直性脊柱炎好发于下肢关节，结合HLA-B27检查，MRI的附着点相关炎症可对其早期诊断。
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