Department of Diagnostic Radiology, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Jeonju, Republic of Korea.
Scand J Rheumatol. 2010 Mar;39(2):141-7. doi: 10.3109/03009740903273197.
To identify the characteristic features of Achilles enthesitis of the spondyloarthropathies (SpA) detectable by colour Doppler energy ultrasound (CDEU) in the context of the 'enthesis organ'.
Seventy patients with SpA and 15 healthy subjects were clinically evaluated and underwent CDEU examination of the Achilles entheses. The CDEU images were evaluated according to five distinctive CDEU features of enthesitis in the context of the enthesis organ.
Fifty-six of the 70 SpA patients (80%) showed at least one abnormal finding of the enthesitis on CDEU examination, affecting 91 of 140 Achilles entheses examined (65%). Only 22 of 140 Achilles entheses (15.7%) showed abnormal vascularization in the peri-sesamoidal and periosteal areas or in the area of enthesis fibrocartilage. In addition, 67 (47.9%) and 18 (12.9%) of 140 Achilles entheses examined showed cortical bone irregularities and erosions, respectively, at areas of the periosteal and the enthesis fibrocartilage. Sixteen (88.9%) of 18 clinically detected Achilles enthesitis and six (75%) of eight Achilles entheses with swelling on clinical examination presented corresponding abnormalities on CDEU examination. The Doppler twinkling artefact (TA) was observed consistently in all normal entheses and completely disappeared upon stabilization of the probe application. The C-reactive protein (CRP) level was higher in the patients with cortical bone erosion than in those without erosion.
This study demonstrates the characteristic features of enthesitis detectable by CDEU in the context of the enthesis organ and shows a good correlation with clinical as well as with laboratory findings.
在“附着器”的背景下，确定脊柱关节炎（SpA）的跟腱附着处炎症的彩色多普勒能量超声（CDEU）可检测到的特征。
对 70 例 SpA 患者和 15 名健康对照者进行临床评估，并对跟腱附着处进行 CDEU 检查。根据附着器背景下附着处炎症的 5 种独特 CDEU 特征对 CDEU 图像进行评估。
70 例 SpA 患者中（80%）有 56 例至少有 1 处跟腱附着处 CDEU 异常，140 个跟腱附着处中有 91 个（65%）异常。只有 22 个（15.7%）跟腱附着处的周围滑囊和骨膜区或附着处纤维软骨区出现异常血管化。此外，140 个跟腱附着处中有 67 个（47.9%）和 18 个（12.9%）分别出现骨皮质不规则和侵蚀，这些异常分别位于骨膜区和附着处纤维软骨区。18 个临床上发现的跟腱附着处中有 16 个（88.9%）和 8 个临床上发现肿胀的跟腱附着处中有 6 个（75%）在 CDEU 检查中发现相应的异常。在所有正常附着处都可以观察到多普勒闪烁伪像（TA），并且在稳定探头应用后完全消失。C 反应蛋白（CRP）水平在出现骨皮质侵蚀的患者中高于无侵蚀的患者。
本研究在附着器的背景下展示了 CDEU 可检测到的附着处炎症的特征，并与临床和实验室发现具有良好的相关性。
