Background Algerian Spondyloarthritis (SpA) is characterized by a high prevalence and more severe axial and articular lesions compared to the caucasian population, What about enthesitis involvement?
Objectives To estimate the global and site-specific clinical and ultrasound prevalence of peripheral enthesitis in an Algerian cohort of SpA
Methods AA monocenter prospective study of all SpA ≥18 years meting the ASA criteria for SpA followed in a rheumatology center at EHS Ben Aknoun over a period from January 2015 to April 2016 Demographic, clinical, lab and ultrasound characteristics were noted. Fifteen enthesic sites were investigated: insertions of supra-spinatus, sub-scapular, medial and lateral epicondylar tendons, triceps brachialis, gluteus medius, quadriceps proximal and distal insertion (patellar ligament, medial and lateral collateral ligament), Achilles tendon, plantar aponeurosis. These sites were assessed clinically and ultrasonographically during the same consultation to determine the global and site-specific clinical and ultrasound prevalence of peripheral enthesitis. Elementary ultrasonographic lesions were noted. The comparison between clinical and ultrasound prevalence was performed using the Mac Nemar test using the SPSS software.
Results A total of 208 patients were included, mainly men (63.5%). The mean age was 40.2±11.7 years. The mean duration of the SpA was 11.8±8.7 years. Axial radiographic SpA was the most frequent phenotype (69.2%) and ankylosing spondylarthritis was the most frequent sub-group (57.7%). At examination, 88.9% had an active disease (ASDAS-vs and/or ASDAS-crp>1.3) and 64.4% of SpAs were taking NSAID 6240 entheses were assessed clinically and 7072 entheses examined with ultrasound
Figure 1 summarizes the prevalence of elementary ultrasound lesions per site.
Conclusions In this cohort and as expected, ultrasound (with at least one elementary lesion) was superior to clinical examination for the detection of peripheral enthesitis (83.2 vs. 44.2%, P<0.001). Interesting sites to explore according to the prevalence and to the presence of a Doppler signal (<2mm/cortical) would be insertions of the calcaneal, quadricipital, patellar, gluteal, plantar aponeurosis and triceps brachialis tendons.
Disclosure of Interest None declared
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