Rheumatology and Rehabilitation Department, Minia University, Minia, Egypt.
Clin Rheumatol. 2012 Apr;31(4):697-704. doi: 10.1007/s10067-011-1911-2. Epub 2011 Dec 28.
The aims of the study were to detect the frequency of involvement of the Achilles tendon and plantar fascia in patients with calcium pyrophosphate deposition disease (CPPD) by high-frequency gray-scale ultrasonography (US) and power Doppler sonography (PDS) and to correlate these findings with demographic and clinical data. Two groups of patients were enrolled: group I (38 patients with CPPD) and group II (22 patients with knee OA). US/PDS examination of the heels was performed to both groups. In the CPPD group, US/PDS examination of the Achilles tendon revealed: calcification in 57.9%, enthesophytosis in 57.9%, enthesopathy in 23.7%, vascular sign in 21%, bursitis in 13.2%, and cortical bone irregularity in 10.5%. US/PDS examination of plantar fascia in the CPPD group revealed: calcification in 15.8%, cortical bone irregularity in 78.9%, enthesophytosis in 60.5%, and planter fasciitis in 42.1%. In patients with CPPD, age was significantly correlated with enthesophytosis and deep retrocalcaneal bursitis (p = 0.01 and p = 0.04, respectively). Heel tenderness and posterior talalgia were significantly correlated with Achilles tendon enthesopathy, vascular sign, and deep retrocalcaneal bursitis (p = 0.0001 for each). Inferior talalgia was significantly correlated with plantar fasciitis (p = 0.0001). The sensitivity of ultrasonography for detection of calcifications in Achilles tendon and plantar fascia was 57.9% and 15.8%, respectively, and the specificity was 100% for both. To conclude, ultrasonographic Achilles tendon and plantar fascia calcifications are frequent findings in patients with CPPD. These calcifications have a high specificity and can be used as a useful indirect sign of CPPD.
本研究旨在通过高频灰阶超声（US）和能量多普勒超声（PDS）检测焦磷酸钙沉积病（CPPD）患者的跟腱和足底筋膜受累频率，并将这些发现与人口统计学和临床数据相关联。我们纳入了两组患者：组 I（38 例 CPPD 患者）和组 II（22 例膝骨关节炎患者）。对两组患者的足跟进行 US/PDS 检查。在 CPPD 组中，US/PDS 检查发现跟腱有：钙化 57.9%，腱骨赘 57.9%，腱病 23.7%，血管征象 21%，滑囊炎 13.2%，皮质骨不规则 10.5%。CPPD 组足底筋膜的 US/PDS 检查显示：钙化 15.8%，皮质骨不规则 78.9%，腱骨赘 60.5%，足底筋膜炎 42.1%。在 CPPD 患者中，年龄与腱骨赘和深部跟腱滑囊炎显著相关（p = 0.01 和 p = 0.04）。足跟压痛和后足痛与跟腱腱病、血管征象和深部跟腱滑囊炎显著相关（p = 0.0001）。中足痛与足底筋膜炎显著相关（p = 0.0001）。超声检测跟腱和足底筋膜钙化的敏感性分别为 57.9%和 15.8%，特异性均为 100%。总之，超声检查发现 CPPD 患者的跟腱和足底筋膜钙化是常见表现。这些钙化具有高度特异性，可作为 CPPD 的有用间接征象。
