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Relationship Between Ultrasound and Physical Examination in the Assessment of Enthesitis in Patients With Spondyloarthritis: Results From the DEUS Multicenter Study
A. Di Matteo, S. Di Donato, G. Smerilli, A. Becciolini, F. Camarda, A. Cauli, T. Cazenave, E. Cipolletta, D. Corradini, JJ. de Agustin, GM. Destro Castaniti, E. Di Donato, E. Duran, B. Farisogullari, M. Fornaro, F. Francioso, P. Giorgis, R....
Language English Country United States
Document type Journal Article, Multicenter Study
PubMed
39165013
DOI
10.1002/art.42971
Knihovny.cz E-resources
- MeSH
- Achilles Tendon diagnostic imaging MeSH
- Axial Spondyloarthritis diagnostic imaging MeSH
- Adult MeSH
- Enthesopathy * diagnostic imaging MeSH
- Physical Examination * MeSH
- Middle Aged MeSH
- Humans MeSH
- Cross-Sectional Studies MeSH
- Arthritis, Psoriatic diagnostic imaging complications MeSH
- Spondylarthritis * diagnostic imaging complications MeSH
- Ultrasonography * MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
OBJECTIVE: The study objectives were (i) to explore the agreement between the Outcome Measures in Rheumatology (OMERACT) ultrasound lesions of enthesitis and physical examination in assessing enthesitis in patients with spondyloarthritis (SpA) and (ii) to investigate the prevalence and clinical relevance of subclinical enthesitis in this population. METHODS: Twenty rheumatology centers participated in this cross-sectional study. Patients with SpA, including axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA), underwent both ultrasound scan and physical examination of large lower limb entheses. The OMERACT ultrasound lesions of enthesitis were considered, along with a recently proposed definition for "active enthesitis" by our group. Subclinical enthesitis was defined as the presence of "active enthesitis" in ≥1 enthesis in patients with SpA without clinical enthesitis (ie, number of positive entheses on physical examination and Leeds Enthesitis Index score = 0). RESULTS: A total of 4,130 entheses in 413 patients with SpA (224 with axSpA and 189 with PsA) were evaluated through ultrasound and physical examination. Agreement between ultrasound and physical examination ranged from moderate (ie, enthesophytes) to almost perfect (ie, power Doppler and "active enthesitis"). Patellar tendon entheses demonstrated the highest agreement, whereas Achilles tendon insertion showed the lowest. Among 158 (38.3%) of 413 patients with SpA with clinical enthesitis, 108 (68.4%) exhibited no "active enthesitis" on ultrasound. Conversely, of those 255 without clinical enthesitis, 39 (15.3%) showed subclinical enthesitis. Subclinical enthesitis was strongly associated with local structural damage. However, no differences were observed regarding the demographic and clinical profiles of patients with SpA with and without subclinical enthesitis. CONCLUSION: Our study underscores the need for a comprehensive tool integrating ultrasound and physical examination for assessing enthesitis in patients with SpA.
Azienda Ospedaliera Universitaria and University of Cagliari Monserrato Italy
Azienda Ospedaliero Universitaria di Parma Parma Italy
Carlo Urbani Hospital and Polytechnic University of Marche Ancona Italy
Centro Hospitalar de Leiria Leiria Portugal and University of Beira Interior Covilhã Portugal
Centro Hospitalar e Universitário de Coimbra University of Coimbra Coimbra Portugal
Guangdong Provincial People's Hospital and Southern Medical University Guangdong China
Hacettepe University Ankara Turkey
Hokkaido Medical Center for Rheumatic Diseases Sapporo Japan
Hospital Italiano de Buenos Aires Buenos Aires Argentina
Hospital Juárez de México Mexico City Mexico
Hospital San Roque de Gonnet La Plata Argentina
Institute of Psychophysical Rehabilitation Buenos Aires Argentina
IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna Italy
Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca Romania
National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra Mexico City Mexico
Reina Sofia University Hospital Cordoba Spain
University Hospital Motol Prague Czech Republic
University of Ioannina Ioannina Greece
University of Leeds NIHR Leeds BRC Leeds United Kingdom
References provided by Crossref.org
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