Department of PRM, Ankara University School of Medicine, Ankara, Turkey.
Rheumatology Department, Department of PRM, Ankara University School of Medicine, Ankara, Turkey.
Int J Rheum Dis. 2020 Apr;23(4):511-519. doi: 10.1111/1756-185X.13796. Epub 2020 Jan 26.
The aim is to evaluate Achilles tendon enthesopathy with ultrasound (US) in ankylosing spondylitis (AS) and non-radiographic axial SpA (nr-axSpA) patients and controls, and compare these groups in terms of associations between disease activity parameters and ultrasonographic Achilles enthesitis signs.
A total of 24 AS and 20 nr-axSpA patients fulfilling the Assessment in Spondyloarthritis International Working Group criteria for axSpA and 30 controls were enrolled. Demographic characteristics, erythrocyte sedimentation rate, C-reactive protein (CRP), human leukocyte antigen (HLA)-B27, Bath AS Disease Activity Index, Bath AS Functional Index, Bath AS Metrology Index, Maastricht AS Enthesitis Score (MASES), AS Disease Activity Score-CRP, modified Stoke AS Spine Score (m-SASSS) scores and ultrasonographic findings were noted.
HLA-B27 positivity, extra-articular and peripheral involvement, disease activity, functional status, mean m-SASSS, ultrasonographic gray scale (GS) and total scores were similar between AS and nr-axSpA groups. In GS, tendon echotexture scores were significantly different across all groups (0.812 ± 0.384 in AS, 0.575 ± 0.466 in nr-axSpA, 0.017 ± 0.091 in controls; P < .001). Entheseal calcification scores were similar in AS and nr-axSpA patients, and higher than controls (P = .001). Bone profile scores were similar in patients with AS and nr-axSpA, and higher than controls (P = .010). When the correlations between US findings and disease activity and functional status were considered, power Doppler US (PDUS) and MASES total scores were positively correlated in the AS group (P = .045; r = .41).
AS and nr-axSpA patients were found to be similar in various clinical, functional, and US findings indicating that these 2 entities are different phenotypic reflections of the same disease spectrum. The positive correlation between PDUS and MASES scores in AS patients substantiate the performance of MASES in evaluation of entheseal activity.
评估超声（US）在强直性脊柱炎（AS）和非放射学中轴型脊柱关节炎（nr-axSpA）患者中的跟腱附着病，并比较这些组在疾病活动参数与超声跟腱附着炎征象之间的相关性。
共纳入 24 例符合中轴型 SpA 国际工作组（ASAS）标准的 AS 和 20 例 nr-axSpA 患者，以及 30 名对照者。记录人口统计学特征、红细胞沉降率、C 反应蛋白（CRP）、人类白细胞抗原（HLA）-B27、Bath AS 疾病活动指数、Bath AS 功能指数、Bath AS 计量学指数、马斯特里赫特 AS 附着病评分（MASES）、AS 疾病活动评分-CRP、改良斯道克 AS 脊柱评分（m-SASSS）和超声结果。
AS 和 nr-axSpA 组的 HLA-B27 阳性率、关节外和外周受累、疾病活动、功能状态、平均 m-SASSS、超声灰阶（GS）和总分相似。在 GS 中，肌腱回声纹理评分在所有组中均有显著差异（AS 组为 0.812±0.384，nr-axSpA 组为 0.575±0.466，对照组为 0.017±0.091；P<0.001）。AS 和 nr-axSpA 患者的附着点钙化评分相似，高于对照组（P=0.001）。骨轮廓评分在 AS 和 nr-axSpA 患者中相似，高于对照组（P=0.010）。当考虑 US 发现与疾病活动和功能状态的相关性时，在 AS 组中，能量多普勒超声（PDUS）和 MASES 总分呈正相关（P=0.045；r=0.41）。
AS 和 nr-axSpA 患者在各种临床、功能和 US 发现方面相似，表明这两种实体是同一疾病谱的不同表型反映。AS 患者中 PDUS 和 MASES 评分之间的正相关证实了 MASES 在评估附着点活性方面的性能。
