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Assessment of peripheral enthesitis in the spondylarthropathies by ultrasonography combined with power Doppler: A cross-sectional study
- Publication Year :
- 2003
- Publisher :
- WILEY-LISS, 2003.
-
Abstract
- Objective To assess the prevalence and severity of peripheral enthesitis among the different subtypes of spondylarthropathy (SpA) by using ultrasonography (US) in B mode with power Doppler. Methods One hundred sixty-four consecutive patients with SpA (according to the criteria of the European Spondylarthropathy Study Group) and 64 control patients (34 with mechanical low back pain [MBP] and 30 with rheumatoid arthritis [RA]) underwent US examination of major entheses of their limbs. Particular attention was given to the detection of vascularization at the following sites: cortical bone insertion of entheses, junction between tendon and entheses, body of tendon, and bursa. Results Abnormal US findings consistent with at least one enthesitis were observed in 161 of 164 SpA patients (98%), affecting 1,131 of 2,952 entheses examined (38%). In contrast, only 132 of 1,152 entheses (11%) were found to be abnormal in 33 of 64 control patients (52%). US enthesitis was most commonly distributed in the distal portion of the lower limbs, irrespective of SpA subtype and of skeletal distribution of clinical symptoms. None of the abnormal entheses in control patients showed vascularization, compared with 916 of 1,131 abnormal entheses in SpA patients (81%), where it was always detected at the cortical bone insertion and sometimes also in the bursa. In SpA patients, the US pattern depended on the clinical presentation, with a higher prevalence of the most severe stages in those with peripheral forms. Conclusion US in B mode combined with power Doppler allowed the detection of peripheral enthesitis in a majority of SpA patients, but not in MBP or RA patients. The presence of entheseal involvement was independent of SpA subtype, but its degree of severity appeared to be greater in peripheral forms. US could be very useful for both the diagnosis and the assessment of SpA activity.
- Subjects :
- Adult
Male
medicine.medical_specialty
Pathology
Settore MED/16 - REUMATOLOGIA
Cross-sectional study
Immunology
Severity of Illness Index
Arthritis, Rheumatoid
Tendons
Rheumatology
Rheumatoid
medicine
Prevalence
Immunology and Allergy
Humans
Pharmacology (medical)
Spondylarthropathies
Ultrasonography
Ligaments
business.industry
Arthritis
Enthesitis
Doppler
Ultrasonography, Doppler
Middle Aged
Enthesis
medicine.disease
Tendon
Peripheral
medicine.anatomical_structure
Cross-Sectional Studies
Rheumatoid arthritis
Tendinopathy
Cortical bone
Female
Radiology
medicine.symptom
business
Low Back Pain
Joint Capsule
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....f55c1972ef40391761b28639f7fd7957