Background Enthesitis is considered as the primary anatomical lesion in spondyloarthropathy (SpA) but it can be seen in other rheumatologic diseases. Its locations and clinical relationships have not been studied well in the literature.
Objectives We aimed to investigate the frequency of ultrasonographic, clinical enthesopathy and the relationship between enthesopathy and disease activity, functional status in patients with rheumatoid arthritis (RA) and axial SpA.
Methods Thirty three axial SpA, 21 RA patients and 30 healthy subjects were included in the study. The clinical and functional evaluations relied on the BASDAI, BASFI, ASQoL, DAS28, and HAQ, and on a VAS for entheseal pain, as well as on the MASEI. Knee, ankle and elbow were examined with US bilaterally in 172 joint regions.
Results The physical examination scores for enthesitis were 1.97±2.68, 2.43±1.80, 0.23±0.12 in axial SpA, RA and healthy subjects, respectively. There was no statistically significant difference between axial SpA and RA about enthesitis physical examination scores (p=0.123). A statistically significant difference was not found between axial SpA and RA in quadriceps tendon enthesitis and distal patellar ligament enthesitis according to MASEI index (MASEI 3,4,5) (p=0.993, p=0.124, p=0.652). Other MASEI enthesit scores were statistically higher in axial SpA group than RA and healthy subjects (p=0.008). Positive correlations were found between BASDAI scores and enthesitis pyhsical examination scores, MASEI total scores (r=0.739, p=0.0001, r=0.516, p=0.002). There was moderately positive correlation between ASQoL total scores and MASEI total scores (r=0.466, p=0.006). HAQ total scores were not correlated with MASEI total scores (r=0.213, p=0.065).
Conclusions Ultrasonographic enthesitis was associated with impaired quality of life in axial SpA. MASEI 1 and 2 was spesific entheseal regions in MASEI index for axial SpA. Different from RA, the calcaneal enthesitis region for clinical investigation and ultrasonographic enthesopathy should be focused on in axial SpA.
Disclosure of Interest None declared
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