Clinica Reumatologica, Università Politecnica delle Marche, Ospedale A. Murri, Via dei Colli, 52, 60035 Iesi, Ancona, Italy.
Clin Rheumatol. 2012 Mar;31(3):463-8. doi: 10.1007/s10067-011-1875-2. Epub 2011 Oct 21.
This study was conducted to determine the prevalence of subclinical entheseal involvement at the greater trochanter level by ultrasound in patients with spondyloarthritis. Forty-six patients with spondyloarthritis and 46 healthy age- and sex-matched controls were studied. All patients with no clinical evidence of enthesopathy at the greater trochanter underwent an ultrasound examination. The following three entheses were scanned bilaterally: anterior insertion of gluteus minimus, anterior insertion of gluteus medius, and posterior insertion of gluteus medius. Ultrasound findings of enthesopathy were thickening, calcifications, bone erosions, enthesophytes, bursitis, and power Doppler signal. A total of 276 entheses were evaluated in spondyloarthritis patients. In 112 out of 276 (40.5%), grayscale ultrasound found enthesopathy. The enthesis with the highest number of signs of enthesopathy was the anterior insertion of gluteus medius (46/276) (16%), followed by posterior insertion of gluteus medius (37/276) (13.4%) and anterior insertion of gluteus minimus (29/276) (10.5%). In the healthy population, ultrasound found entesopathy in 80 out of 276 (29%) entheseal sites (p < 0.0001). Posterior insertion of gluteus medius enthesis was the more frequently involved (34/276) (12.3%), followed by anterior insertion of gluteus medius (24/276) (8.6%) and anterior insertion of gluteus minimus (22/276) (7.9%). Power Doppler was found more frequently in patients with spondyloarthritis compared with healthy controls (1% vs 0%). Our results show a higher prevalence of subclinical enthesopathy at the greater trochanter level in patients with spondyloarthritis than in age- and sex-matched healthy controls.
本研究旨在通过超声检查确定强直性脊柱炎患者大转子水平的亚临床腱骨附着处受累的患病率。研究纳入 46 例强直性脊柱炎患者和 46 例年龄和性别匹配的健康对照者。所有无大转子处腱骨附着处病变临床证据的患者均接受超声检查。双侧扫描以下三个腱骨附着处：臀小肌前附着处、臀中肌前附着处和臀中肌后附着处。超声检查发现的腱骨附着处病变包括增厚、钙化、骨侵蚀、骨赘、滑囊炎和功率多普勒信号。共评估了 276 个腱骨附着处。在 276 个附着处中，112 个（40.5%）出现灰阶超声异常。腱骨附着处病变数量最多的是臀中肌前附着处（46/276）（16%），其次是臀中肌后附着处（37/276）（13.4%）和臀小肌前附着处（29/276）（10.5%）。在健康人群中，276 个附着处中有 80 个（29%）出现超声异常（p<0.0001）。臀中肌后附着处是最常受累的部位（34/276）（12.3%），其次是臀中肌前附着处（24/276）（8.6%）和臀小肌前附着处（22/276）（7.9%）。与健康对照组相比，强直性脊柱炎患者的附着处出现功率多普勒信号更为常见（1%比 0%）。我们的研究结果显示，与年龄和性别匹配的健康对照组相比，强直性脊柱炎患者大转子水平的亚临床腱骨附着处病变患病率更高。
