Effect of Enthesitis on 1505 Brazilian Patients with Spondyloarthritis

Abstract

The clinical presence of enthesitis in this large cohort of patients with SpA was frequent and was associated with a significant increase in disease activity and decline in functional capacity and quality of life.

Clinical Enthesitis in a Prospective Longitudinal Psoriatic Arthritis Cohort: Incidence, Prevalence, Characteristics, and Outcome

“…Most patients in our study had up to 2 tender enthesitis sites. This number is similar to the INSPIRE study, which reported a median of 1.8 enthesitis sites among PsA patients, and to another study that reported a mean of 2.1 affected entheseal sites among a large study (1,505 participants) of heterogeneous SpA patients . Interestingly, bilateral involvement was detected in up to one‐fifth of the patients with enthesitis.…”

“…A lower prevalence was detected in population‐based studies from Iceland (8%) and Olmstead County (23%) . A higher prevalence of enthesitis (53.8%) was reported from a multicenter SpA study . These discrepancies can be attributed to the use of different enthesitis indices.…”

“…SPARCC functioned better than the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) in the INSPIRE study, and similar to the Leeds Enthesitis Index (LEI). This difference may explain both the closer numbers to the Ranza et al study, which used the LEI and the difference from the Carneiro et al study , which used the MASES index.…”

Psoriatic Arthritis and Burden of Disease: Patient Perspectives from the Population-Based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) Survey

“…Symptoms resembling enthesitis (i.e., pain/ swelling of heel) were reported by 31% of patients, and symptoms resembling dactylitis (i.e., ''sausage'' digits) were reported by 45% of patients. Enthesitis and dactylitis, important distinguishing features of PsA in many patients, are associated with more severe disease; both can be difficult to treat and can lead to disability [5,13,31]. Approximately twice as many patients with PsA (21%) had nail involvement compared with patients with psoriasis alone (11%), and 44% of patients with PsA reported scalp involvement; however, overall these rates are lower than those previously reported [8,17,18,21,26].…”

2014 Update of the Canadian Rheumatology Association/Spondyloarthritis Research Consortium of Canada Treatment Recommendations for the Management of Spondyloarthritis. Part I: Principles of the Management of Spondyloarthritis in Canada

“…Physical examinations should be relevant to the patient's predominant presenting features, but all patients should have a tender joint count, swollen joint count, and entheseal assessment (LOE IV, SOR D). Enthesitis in SpA has been associated with poorer outcomes and increased disease activity 29,30 . Specific metrology of the spine is not included because the clinical utility and prognostic value of spinal metrology remains under study (LOE IV, SOR D).…”