Spondyloarthritis prevalence in patients with epin calcaneis

When taken into account as a single disease entity spondyloarthrides(SpA) are the most prevalent of rheumatic diseases. Being the hallmark of this group, enthesitis commonly occurs as Achilles' tendinitis and/or plantar fasciitis. Other than SpAs there are many causes of plantar fasciitis, primarily trauma and degenerative diseases. Also known as heel spur, epin calcanei tends to be more prevalent among people suffering from plantar fasciitis. The reason behind this increased prevalance and the relationship between epin calcanei and plantar fasciitis still remains largely unknown. In this study we aimed to observe the prevalance of SpA among people with already diagnosed epin calcaneis. For this study plain lateral foot radiographies of patients who presented to the departments other than rheumatology were scanned. Patients who found to have epin calcanei and aged between 20-40 with no known rheumatic disease were contacted. After signing informed consent, a total of 33 patients were enrolled into the study. A thorough medical history was obtained and physical examination was conducted according to European Spondyloarthropathy Study Group criteria. Eryhtrocyte sedimentation rate and CRP values were obtained, and an anteroposterior plain sacroiliac graphy were taken for each patient. Contralateral foot radiographies were also taken of the patients with only left or right lateral foot graphies. Ratios of the patients' epin calcaneis' length to their ipsilateral calcaneal oblique measurement were calculated. Both the lengths of epin calcaneis and the ratios were found to be statistically quite different between patients with SpA and patients without (p values for right epin calcaneis and right ratios were 0.041 and 0.034 while for left epin calcaneis and ratios they were 0.001 and 0.000 respectively). This finding, formerly unknown in literature as to our best knowledge, may prove to be a cheap and easy but also a standardized method for detecting SpA. Keywords: spondyloarthritides, epin calcanei, heel spur, plantar fasciitis, European Spondyloarthropathy Study Group (ESSG)