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AB0679 Mardrid Sonographic Enthesis Index Scoring System Is Sensitive for Asymptomatic Peripheral Enthesitis in Early Axial Spondyloarthritis
  1. D.F. Lin1,
  2. Z.Y. Hu1,
  3. M.J. Zhao1,
  4. J.Y. Cao2,
  5. J.R. Gu1
  1. 1Rheumatology department
  2. 2US department, the 3rd Affiliated Hospital of Sun Yet-sen University, Guangzhou, China

Abstract

Background Mardird sonographic enthesis index (MASEI) was one of the most wide used scoring systems for enthesitis not only used in spondyloarthropathy (SpA) but also in the other disease such as enthesitis in Behcet's disease. However, no articles mentioned its role in early diagnose in the early axial SpA without peripheral syndromes yet.

Objectives Our study is to find out the role of MASEI in diagnosis of early axial SpA.

Methods Ultrasound was performed by 2 observers blinded to the other examinations and the final diagnosis. All cases were diagnosed as early axial SpA fulfilling 2009 classification criteria but not 1996 New York Criteria with sacroilliac X-ray and MRI.US examination referred to MASEI related regions. BASDI, ASDAS were employed to assess disease activity. MRI was synchronized done for the position with positive findings by ultrasound to make sure the accuracy of the enthesitis.

Results 1) 168 early axial SpA subjects without proof for peripheral enthesitis including physical examination or past history were screened by ultrasound.47 (28.0%) were made diagnosis as perpheral enthesitis by US and 45 (25.6%) were comfirmed by MRI. Mean age of 45 was 29.3 yrs, female-male ratio was 0.36:1, and disease duration was 0.89 yr. Positive HLA-B27 patients were more than HLA-B27negative ones (4:1).

2) The average of MASEI scores were low level (7.26±2.36). No significant differences between HLA(+) and HLA(−) groups. However, the scores for male patients group was higher than female ones (Sig=0.002), especially in respect of tendon thickness, tendon structure disturbance and bone erosion (Sig=0.000,0.001, 0.011).

3) The most common US findings were the chronic presentations as bone erosion, bone calcification. (75.6%, 84.4%) which suggested the enthesis aggression in asymptomatic patinets is a long-term slow change.

Conclusions Our study found MASEI assessment is good tool for early diagnosis and follow up for peripheral enthesitis in early axial SpA and the US positive findings might be earlier than the clinical presentations.

Disclosure of Interest None declared

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