Clinical and ultrasonographic enthesopathy in inflammatory rheumatic diseases

Süleyman, E.; Nas, Kemal; Harman, Halil; Kaban, Nedim

doi:10.1007/s00393-017-0405-2

Cited by 5 publications

(5 citation statements)

References 25 publications

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“…In another study from our country, BASDAI and total physical examination scores of enthesitis and MASEI scores were positively correlated in SpA patients . Also, we found significant moderate correlation between MASES scores and PD scores but not GS scores in patients with AS in the present study.…”

Section: Discussionsupporting

confidence: 64%

Ultrasonographic evaluation of Achilles tendon: Is there any difference between ankylosing spondylitis, non‐radiographic axial spondyloarthropathy and controls?

et al. 2020

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Purpose:The aim is to evaluate Achilles tendon enthesopathy with ultrasound (US) in ankylosing spondylitis (AS) and non-radiographic axial SpA (nr-axSpA) patients and controls, and compare these groups in terms of associations between disease activity parameters and ultrasonographic Achilles enthesitis signs. Methods:A total of 24 AS and 20 nr-axSpA patients fulfilling the Assessment in Spondyloarthritis International Working Group criteria for axSpA and 30 controls were enrolled. Demographic characteristics, erythrocyte sedimentation rate, C-reactive protein (CRP), human leukocyte antigen (HLA)-B27, Bath AS Disease Activity Index, Bath AS Functional Index, Bath AS Metrology Index, Maastricht AS Enthesitis Score (MASES), AS Disease Activity Score-CRP, modified Stoke AS Spine Score (m-SASSS) scores and ultrasonographic findings were noted. Results: HLA-B27 positivity, extra-articular and peripheral involvement, disease activity, functional status, mean m-SASSS, ultrasonographic gray scale (GS) andtotal scores were similar between AS and nr-axSpA groups. In GS, tendon echotexture scores were significantly different across all groups (0.812 ± 0.384 in AS, 0.575 ± 0.466 in nr-axSpA, 0.017 ± 0.091 in controls; P < .001). Entheseal calcification scores were similar in AS and nr-axSpA patients, and higher than controls (P = .001).Bone profile scores were similar in patients with AS and nr-axSpA, and higher than controls (P = .010). When the correlations between US findings and disease activity and functional status were considered, power Doppler US (PDUS) and MASES total scores were positively correlated in the AS group (P = .045; r = .41). Conclusion: AS and nr-axSpA patients were found to be similar in various clinical, functional, and US findings indicating that these 2 entities are different phenotypic reflections of the same disease spectrum. The positive correlation between PDUS and MASES scores in AS patients substantiate the performance of MASES in evaluation of entheseal activity. K E Y W O R D S achilles, ankylosing spondylitis, enthesitis, non-radiographic axial spondyloarthritis, ultrasound

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Section: Discussionsupporting

confidence: 64%

Ultrasonographic evaluation of Achilles tendon: Is there any difference between ankylosing spondylitis, non‐radiographic axial spondyloarthropathy and controls?

et al. 2020

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“…Most of the previous studies have failed to show any correlation between US and BASDAI,[ 12 , 17 , 36 , 38 , 39 , 41 , 42 ] besides a few studies. [ 18 , 19 , 40 ] Although these studies may suggest that US may be insufficient for disease activity evaluation, some authors have also argued that the current disease activity scales may be inadequate in expressing the real disease state. [ 43 , 44 ] BASDAI is a subjective measure of symptoms and is based on patients’ responses on a self-administered questionnaire; hence, the score may be affected by other concurrent pain-causing illnesses, such as chronic pain and fibromyalgia.…”

Section: Discussionmentioning

confidence: 99%

“…Hamdi et al[ 16 ] found that Doppler scores were correlated with ASQoL. Suleyman et al[ 19 ] found a moderately significant correlation between ASQoL and MASEI. Nonetheless, further studies are needed to provide adequate information on this subject.…”

Section: Discussionmentioning

confidence: 99%

“…[ 17 , 18 ] In a study utilizing MASEI, authors investigate the correlation among sonographic and clinical evaluation of entheseal sites in MASEI, disease activity, and quality of life but clinical enthesitis indices were not used, functional status was neglected, and the correlation between C-reactive protein (CRP), an important marker of inflammation and disease activity in SpA, was not investigated. [ 19 ] This study aimed to comprehensively evaluate many parameters, including disease activity, quality of life, functional status, clinical enthesitis scores, and ultrasonographical enthesitis assessment, with the MASEI index and to determine how valuable ultrasonographic enthesitis is to assess disease activity, functionality, and quality of life.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between clinical parameters and ultrasonographic enthesitis assessment in patients with spondyloarthritis

Er,

Palamar,

Akgün

et al. 2024

Arch Rheumatol

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Objectives: The study aimed to evaluate the role of ultrasonographic assessment of enthesitis in patients with spondyloarthritis (SpA) in terms of disease activity, functionality, and quality of life. Patients and methods: Ninety SpA patients (57 males, 33 females; mean age: 37.5±9.7 years; range, 18 to 60 years) were included in cross-sectional study between November 2016 and January 2017. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Functional Index (BASFI), Short Form-12 (SF-12), and Ankylosing Spondylitis Quality of Life (ASQoL) were utilized for clinical evaluation. The clinical evaluation of enthesitis was performed with the Spondyloarthritis Research Consortium of Canada (SPARCC) and Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) via an algometer calibrated to 4 kg/cm2 of pressure. Ultrasound evaluation was performed according to Madrid Sonographic Enthesitis Index (MASEI). A total of 2,610 entheseal sites were examined clinically, and 1,080 were assessed ultrasonographically. Results: A significant proportion of enthesitis (463/1,080) was detected on ultrasonographic evaluation but not with clinical enthesitis score (MASES and SPARCC). Although ultrasonographic entheseal evaluation detected enthesitis in at least one enthesis of all patients, 35 of the patients had no enthesitis with clinical examination. The sites most frequently involved in the entheses were the proximal patellar tendon and Achilles tendon. The MASEI score did not correlate with the MASES, SPARCC, BASDAI, SF-12, and ASQoL but moderately correlated with the C-reactive protein (CRP) level (r=0.348), ASDAS-CRP (r=0.294), and BASFI score (r=0.244). Conclusion: The association of ultrasonography scores with CRP levels and ASDAS-CRP indicates that ultrasonography is effective in detecting inflammation. The MASEI score weakly correlates with functionality but not with quality of life. Ultrasonographic evaluation is invaluable and merits to be incorporated into SpA disease scoring system.

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“…1 Regardless of the age of report or the modalities used, conflicting data have been reported until very recently. [3][4][5] Although it has been suggested that enthesitis in RA may be secondary to articular synovial inflammation or based on the involvement of synovial membrane lining the tendon sheaths and the bursae, no direct evidence has yet been reported. 6 In this study, we aimed to find a clue to the fundamental inflammatory process underlying AT enthesis in patients with RA by analyzing the association between the presence of RC bursitis or AT enthesitis and clinical data.…”

Section: Introductionmentioning

confidence: 99%

Retrocalcaneal Bursitis Precedes or Accompanies Achilles Tendon Enthesitis in the Early Phase of Rheumatoid Arthritis

Suzuki

Hidaka

Seri

2018

Clin Med�Insights�Arthritis�Musculoskelet Disord

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The consecutive reports and stored images of ultrasound examinations for 100 symptomatic ankles of 74 patients with rheumatoid arthritis (RA) were reviewed for the presence or absence of retrocalcaneal bursitis (RCB) and Achilles tendon enthesitis (ATE). The ankles were classified into 4 categories based on the presence or absence of RCB or ATE. The number of RCB(−)/ATE(−), RCB(+)/ATE(−), RCB(+)/ATE(+), and RCB(−)/ATE(+) ankles was 62, 16, 12, and 10, respectively. When classifying patients into early RA and established RA, the percentage of RCB(−)/ATE(+) ankles with early RA was significantly lower than that with established RA (P = .00595). The disease duration was significantly longer in the RCB(−)/ATE(+) ankles than in the RCB(+)/ATE(−) ankles (median [interquartile range]: 15.29 [8.69] months vs 3.6 [3.06] months, P = .0247). It was speculated that RCB precedes or accompanies ATE in the early phase of RA, which suggests that entheseal inflammation in RA arises from synovial tissues.

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Clinical and ultrasonographic enthesopathy in inflammatory rheumatic diseases

Abstract: Compared to RA, US and clinical examination of enthesitis in patients with axial SpA should focus on the calcaneal enthesitis region. In axial SpA, ultrasonographic enthesitis is associated with impaired quality of life.

Cited by 5 publications

References 25 publications

Ultrasonographic evaluation of Achilles tendon: Is there any difference between ankylosing spondylitis, non‐radiographic axial spondyloarthropathy and controls?

Ultrasonographic evaluation of Achilles tendon: Is there any difference between ankylosing spondylitis, non‐radiographic axial spondyloarthropathy and controls?

The relationship between clinical parameters and ultrasonographic enthesitis assessment in patients with spondyloarthritis

Retrocalcaneal Bursitis Precedes or Accompanies Achilles Tendon Enthesitis in the Early Phase of Rheumatoid Arthritis

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