Value of musculoskeletal ultrasonography in the diagnosis of peripheral enthesopathy in early spondyloarthropathy

Abstract EN

-Objective The aim of the study was to evaluate peripheral enthesopathy ultrasonography in early spondyloarthritis. Patients and methods A total of 50 patients were divided into two groups: group I included 30 patients who were diagnosed as spondyloarthropathy (SpA) and were divided into two subgroups – axial subgroup (19 patients) and peripheral subgroup (11 patients) – and group II included 20 patients diagnosed as rheumatoid arthritis.

All patients were subjected to history taking, clinical examination and laboratory and radiological investigations: plain radiography and musculoskeletal ultrasonography. Results A significant difference was found between subgroups regarding clinical examination of plantar fascia, distal patellar ligament and proximal patellar ligament.

We found a high significant difference between mean of Bath Ankylosing Spondylitis Metrology Index (BASMI) in axial (0.8 ± 0.6) and peripheral (0.09 ± 0.3) patients.

A high significant difference was found between group I and group II regarding Madrid Sonographic Enthesitis Index (MASEI).

In addition, a significant difference was found regarding the number of abnormal enthesis examined by ultrasonography. We found a highly significant difference between groups regarding structure, bursa, erosion, calcification and power Doppler scores (higher in group I); a significant difference was found between groups regarding distal patellar ligament thickness, calcification and power Doppler signal; proximal patellar ligament thickness, calcification and power Doppler and quadriceps tendon structure, thickness and power Doppler.

We found significant difference between subgroups regarding structure score. Conclusion Enthesis are affected