Session Type: Abstract Submissions (ACR)
Background/Purpose Inflammatory involvement of peripheral enthesis belongs to an important sign of spondyloarthritis (SpA). It may occur in patients with long-term as well as newly diagnosed disease and in those with definite ankylosing spondylitis (AS) and without radiological sacroiliitis, non-radiographic axial SpA (nr-ax-SpA).
In our work we look for active and non-active entheseal changes by an ultrasound detection in four localization: Achilles tendon, patellar ligament, plantar aponeurosis and quadriceps insertion in patients suffering from newly diagnosed nr-ax-SpA and AS.
The total of 34 patients with newly diagnosed SpA (with established diagnosis maximally within 2 years) underwent the clinical and ultrasound examination. Disease activity was determined by ASDAS CRP and BASDAI. Conventional two-dimensional power Doppler ultrasonography was performed by one radiologist/musculoskeletal ultrasound specialist. Six ultrasound changes like tendon structural changes and thickening of tendon insertion, calcifications, bone erosions, bursitis, and Doppler signal was determined in four locations and Naredo et al. classification for active/non active lesions was used. The χ2 test for comparison each group, Fisher exact test and correlation for activity a tendon changes was used.
Altogether, 26 nr-ax-SpA patients and 8 AS patients BASDAI 3.27±0.56 and 1.95±0.2 respectively, ASDAS CRP 1.88±0.63 and 2.07±0.29 respectively, underwent the ultrasound detection for entheseal changes.
When we look for any changes in all tested tendons there were non-active changes in only 37.90 % nr-ax-SpA compared to 71.88 % AS (p < 0.0001). However the active changes were distributed evenly in nr-ax-SpA and AS, 4.80 % and 7.81%, respectively.
The Doppler positive changes in any locations were found in 19.20% nr-ax-SpA and 37.5% AS (p=ns), whereas the non-active changes in 280.77% nr-ax-SpA a 100% AS (p=ns).
The Achilles tendon and the patellar ligament were the most common involved sites in both patients groups, nr-ax-SpA (32.70 and 26.92%, respectively) and AS (50.0 and 25.0% respectively), all p=ns.
There is no correlation between ASDAS CRP and/or BASDAI and active and non-active lesions in both group.
Our study demonstrates the usefulness of soft tissue ultrasound for active and non-active tendon changes in SpA. Interestingly, both patients with nr-ax-SpA and those with definite AS develop the same number of active entheseal changes, but non-active entheseal changes are more common AS. The presence of active and non-active entheseal changes do not correlate with disease activity.
This study was supported by the project (MH CR) for conceptual development of research organization 023728
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/differences-in-localization-and-activity-of-the-entheseal-involvement-between-non-radiographic-and-radiographic-axial-spondyloarthritis-by-the-ultrasound-assessment/