Background Enthesitis is one of the most common and specific manifestations of spondyloarthropathy (SpA). Ultrasonography has demonstrated to be a highly sensitive tool in the evaluation of entheses in patients with spondyloarthropathy (SpA).
Objectives The objectives of the study were to determine the prevalence of subclinical entheseal involvement in spondyloarthropathy patients in lower limbs.
Methods The study was included 25 patients with spondylarthritis – 15 with ankylosing spondylitis and 10 with psoriatic arthritis, without known history of entheseal involvement. Besides, 20 healthy sex- and age-matched controls were included. All patients with no clinical evidence of arthritis or enthesitis underwent an US examination. All US findings were identified according to GUESS. Clinical examination and ultrasound were consecutively performed at each of the entheses to detect signs indicative of enthesopathy.
Results A total of 246 enthesis in patients with ankylosing spondylitis and psoriatic arthritis (due to the psoriatic lesions on the knee) were evaluated by US. In 88 of 246 (35.77%) entheses, grayscale US found signs indicative of enthesopathy and in 17/246 (6.9%) entheses PD signal was detected. In the healthy population, US found signs of enthesopathy in 12 of 200 (6.0%) entheses and no PD signal was detected. The GUESS score was higher in patients with ankylosing spondylitis than in the psoriasis group, and both scores were significantly higher than in healthy controls (P<0.0001).
Conclusions Our results indicate that both grayscale US and PD findings demonstrate a higher sensitivity for enthesopathy of ultrasonography, with respect to physical examination indicative. Due to the US ability to detect signs of subclinical enthesopathy, further study is needed about the prognostic value of the ultrasound findings for predicting clinical onset of entheseal involvement.
Disclosure of Interest None Declared
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