Enthesis erosion in spondyloarthritis is not a persistent structural lesion

Miguel, Eugenio de; Falcão, Sandra; Castillo, Concepción Castillo; Plasencia, C.; García, Miriam; Branco, Jaime; Martı́n-Mola, Emilio

doi:10.1136/annrheumdis-2011-200352

Cited by 22 publications

(8 citation statements)

References 16 publications

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“…In particular, erosion seems to be an indicator for enthesis US in disease activity. De Miguel et al reported that Achilles erosion had a signi cant association with objective disease activity in spondyloarthritis [29]. In addition, there was no signi cant difference in the calci cation score between the AS and control groups in the results of the present study.…”

Section: Discussioncontrasting

confidence: 43%

Ultrasound Assessment of Entheses and Correlations Between Disease Activity and Ultrasound Scores in Ankylosing Spondylitis: A Cross Sectional Study

Xie¹,

Zhou²,

Luo³

et al. 2020

Preprint

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Background: An increasing number of studies have applied ultrasound (US) to evaluate enthesitis in spondyloarthritis. However, there is no clear agreement on which sites should be evaluated for enthesitis. Furthermore, there are different opinions on whether US can monitor disease activity. The objectives of this study were to evaluate the common involvement of entheses and correlations between disease activity and US scores in ankylosing spondylitis (AS).Methods: A cross-sectional, monocentric, and controlled study was performed. US was used to scan 34 entheses per person and the Madrid sonography enthesitis index (MASEI) score was used. US scores were used to evaluate the elemental lesions of hypoechogenicity, thickness, erosion, calcification, bursitis, and Doppler signal. Disease activity was assessed by Disease Activity Score–C reactive protein (ASDAS-CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).Results: 104 patients with AS and 50 control subjects were included. A total of 5236 entheses were assessed. Compared with the control subjects, only three entheses – the Achilles tendon (AT), sternoclavicular joint (SCJ), and costochondral joint (CCJ) – showed significant differences in the AS group (p < 0.05). Patients with high disease activity (ASDAS-CRP ≥ 2.1) had higher scores than patients with low activity (ASDAS-CRP < 2.1) in erosion (p = 0.02). Patients who were categorized in very high disease activity (ASDAS-CRP ≥ 3.5) had a higher score in erosion (p = 0.02). The erosion score was moderately associated with ASDAS-CRP and BASDAI (r = 0.44, r = 0.21).Conclusions: The commonly involved entheses were the AT, SCJ, and CCJ in AS. Erosion occurred more often in patients with disease activity or high activity. Erosion would be more useful for monitoring disease activity in AS.

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Section: Discussioncontrasting

confidence: 43%

Ultrasound Assessment of Entheses and Correlations Between Disease Activity and Ultrasound Scores in Ankylosing Spondylitis: A Cross Sectional Study

Xie¹,

Zhou²,

Luo³

et al. 2020

Preprint

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“…Recent studies have indicated that ultrasound may accurately predict which patients will go on to develop SpA . In one investigation, ultrasound examination of Achilles erosions correlated with objective activity‐based measurements of SpA outcomes, and was sensitive to change . In the study by D'Agostino and colleagues described above, vascularized enthesis as detected by PDUS combined with Amor's criteria proved to be the only independent contributors to a diagnosis of SpA .…”

Section: Imaging Of the Enthesismentioning

confidence: 97%

Review: Enthesitis: New Insights Into Pathogenesis, Diagnostic Modalities, and Treatment

Kehl

Corr

Weisman

2016

Arthritis & Rheumatology

134

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“…US proved to be sensitive to change when monitoring enthesis erosions at 6 and 12 months and the method is a useful tool for assessing these kinds of modifications [76].…”

Section: Enthesitis Ultrasound and Disease Activity Monitoringmentioning

confidence: 99%

Concepts in monitoring enthesitis in patients with spondylarthritis- the role of musculoskeletal ultrasound

Micu

Fodor

2016

Med Ultrason

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Enthesitis is the key pathological lesion in the spondyloarthritides group and an important element for early diagnosis with a predictive and prognostic value. The recognition of enthesitis on a clinical basis alone remains a challenge and creates unnecessary delays in diagnosis and adequate treatment commencement. Musculoskeletal ultrasound is a valid, reliable, and feasible imaging tool valuable for identifying inflammatory and structural lesions at enthesis level, helpful in establishing a diagnosis, evaluating disease activity and therapy monitoring. This paper focuses on the most relevant aspects of current literature regarding enthesitis and highlights the musculoskeletal ultrasound added value in enthesis assessment.

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Enthesis erosion in spondyloarthritis is not a persistent structural lesion

Abstract: US examination of Achilles erosions is reliable and sensitive to change. An association was found between Achilles erosions and objective activity-based measurements of SpA outcomes.

Cited by 22 publications

References 16 publications

Ultrasound Assessment of Entheses and Correlations Between Disease Activity and Ultrasound Scores in Ankylosing Spondylitis: A Cross Sectional Study

Ultrasound Assessment of Entheses and Correlations Between Disease Activity and Ultrasound Scores in Ankylosing Spondylitis: A Cross Sectional Study

Review: Enthesitis: New Insights Into Pathogenesis, Diagnostic Modalities, and Treatment

Concepts in monitoring enthesitis in patients with spondylarthritis- the role of musculoskeletal ultrasound

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