Kisaarslan Aysenur Pac, Sozeri Betul, Sahin Nihal, Cicek Sumeyra Ozdemir, Gunduz Zubeyde, Poyrazoglu Hakan, Dusunsel Ruhan
Department of Pediatric Rheumatology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
Department of Pediatric Rheumatology, Umraniye Training and Research Hospital, Istanbul, Turkey.
North Clin Istanb. 2020 Jun 17;7(6):591-596. doi: 10.14744/nci.2020.54037. eCollection 2020.
Subclinical inflammation is still a controversial issue in inflammatory diseases. There is no reliable, easy, and cheap inflammation marker in daily clinical practices currently. This study aims to predict clinical remission using cartilage and tendon thicknesses.
Eleven patients with Familial Mediterranean Fever (FMF) who had musculoskeletal involvement before and 11 patients with Enthesitis-Related Arthritis (ERA) were included in this study. They were on remission with clinical and laboratory evaluations for at least three months. Demographic and clinical features of the subjects, including age, sex, body mass index, disease duration, age at onset, medical treatment, and laboratory evaluations, were all noted. Healthy children of the same age were included as the control group. The thicknesses of the bilateral knee, second metacarpophalangeal and ankle joints cartilages, quadriceps, superior and inferior patellar, and the Achilles tendons were measured with a linear probe. A total of 198 joint and 264 tendon thicknesses were measured.
The thicknesses of metacarpophalangeal, knee, and ankle cartilages were higher in the FMF group than in the others. In the FMF group, the quadriceps tendon thickness was higher than in the ERA group, and the superior patellar tendon thickness was higher than in the control group (p<0.05).
According to our preliminary findings, an increased thickness of the cartilage and tendon in FMF patients may be an indicator of subclinical inflammation. Increased thickness of the enthesis in FMF patients may also indicate that enthesitis-related arthritis will also develop in the future.
亚临床炎症在炎症性疾病中仍是一个有争议的问题。目前在日常临床实践中尚无可靠、简便且廉价的炎症标志物。本研究旨在利用软骨和肌腱厚度预测临床缓解情况。
本研究纳入了11例既往有肌肉骨骼受累的家族性地中海热(FMF)患者和11例附着点炎相关关节炎(ERA)患者。他们经临床和实验室评估处于缓解状态至少三个月。记录了受试者的人口统计学和临床特征,包括年龄、性别、体重指数、病程、发病年龄、药物治疗及实验室评估结果。纳入了同龄健康儿童作为对照组。使用线性探头测量双侧膝关节、第二掌指关节和踝关节软骨、股四头肌、髌上和髌下以及跟腱的厚度。共测量了198个关节和264条肌腱的厚度。
FMF组的掌指关节、膝关节和踝关节软骨厚度高于其他组。在FMF组中,股四头肌腱厚度高于ERA组,髌上肌腱厚度高于对照组(p<0.05)。
根据我们的初步研究结果,FMF患者软骨和肌腱厚度增加可能是亚临床炎症的一个指标。FMF患者附着点厚度增加也可能表明未来也会发生附着点炎相关关节炎。