Date: Monday, October 22, 2018
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Enteropathic arthritis (EA) belongs to the spondyloarthritis (SpA) spectrum of diseases and occurs in patients affected by inflammatory bowel diseases (IBD). Several works demonstrated that ultrasonography (US) is feasible, reliable and easily accessible means of detecting chronic and active entheseal abnormalities even in a subclinical contest (1,2) in SpA patients. Aim of our study was to evaluate the prevalence of US entheseal involvement in patients with EA at the level of the distal insertion of patellar ligament.
Methods: Twenty-two consecutive AE patients (12 with Crohn’s disease and 10 with ulcerative colitis; 8 females and 14 males; mean age 44.7 years, range 18-72 years; mean AE duration 10.1 years range 4-21years) and 18 healthy age- and gender-matched controls (8 females and 10 males; mean age 48 years, range 24-68 years) underwent an US examination (ESAOTE MyLAB 70 6-18 MHz linear array transducer) according with the validated Madrid Sonographic Enthesis Index (MASEI). Clinical and clinimetric variables were assessed in both groups according with daily clinical practice.
Results: Focusing on the 44 distal patellar entheses we identified a higher prevalence of all the elementary lesion analysed. In 34 entheses we identify a dishomogeneous echostructure (77.3% vs 33.3%; p= 0.0001), in 38 structural thickness (86.4% vs 66.7%; p= 0.03), in 16 power Doppler positivity (36.3% vs 16.7%; p= 0.04), in 17 presence of calcifications (38.6% vs 16.7%; p= 0.03) and in 8 entheses the presence of erosions (18.8% vs 0%; p= 0.007). A simultaneous presence in the same enthesis of dishomogeneous echostructure, structural thickness and power Doppler positivity suggestive for US active enthesitis was found in the 45% of the examined patients.
Conclusion: US detectable signs of enthesopathy and enthesitis are very frequent in EA patients even when we analyse only the distal enthesis of the patellar ligament. Further studies involving a larger number of patients are needed to confirm these preliminary data.
To cite this abstract in AMA style:Batticciotto A, Prato G, Antivalle M, Ditto MC, Agosti M, Cumbo E, Talotta R, Atzeni F, Sarzi-Puttini P. Ultrasonographic Evaluation of the Enthesis in Patients Affected By Entheropatic Spondiloarthritis. Focus on Distal Enthesis of the Patellar Tendon [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/ultrasonographic-evaluation-of-the-enthesis-in-patients-affected-by-entheropatic-spondiloarthritis-focus-on-distal-enthesis-of-the-patellar-tendon/. Accessed January 20, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/ultrasonographic-evaluation-of-the-enthesis-in-patients-affected-by-entheropatic-spondiloarthritis-focus-on-distal-enthesis-of-the-patellar-tendon/