Clinical entesopathy frequency in inflammatory rheumatic diseases and its effect on disease activity and functional end status

Clinical Entesopathy Frequency In Inflammatory Rheumatic Diseases And Its Effect On Disease Activity And Functional End Status INTRODUCTION AND OBJECTIVES: We aimed to investigate the frequency of ultrasonographic, clinical enthesopathy and the relationship between enthesopathy and disease activity, functional status in patients with rheumatoid arthritis (RA) and axial SpA. MATERIALS AND METHODS: Thirty three axial SpA, 21 RA patients and 30 healthy subjects were included the study. The clinical and functional evaluations relied on the BASDAI, BASFI, ASQoL, DAS28, and HAQ, and on a VAS for entheseal pain, as well as on the MASEI. Knee, ankle and elbow were examined with US bilaterally in 172 joint regions. RESULTS: The enthesitis physical examination scores were 1.97 ± 2.68, 2.43 ± 1.80, 0.23 ± 0.12 in axial SpA, RA and healthy subjects, respectively. There was no statistically significant difference between axial SpA and RA about enthesitis physical examination scores (p= 0.123). A significantly significant difference did not find between axial SpA and RA in quadriceps tendon enthesitis and distal patellar ligament enthesitis according to MASEI index (MASEI 3,4,5) (p=0.993, p=0.124, p=0.652). Other MASEI enthesit scores were statistically higher in axial SpA group than RA and healthy subjects (p=0.008). Positive correlations were found between BASDAI scores and enthesitis pyhsical examination scores, MASEI total scores (r= 0.739, p= 0.0001, r=0.516, p=0.002). There was moderately positive correlation between ASQoL total scores and MASEI total scores (r=0.466, p=0.006). HAQ total scores did not correlate with MASEI total scores (r=0.213, p=0.065). CONCLUSION: Ultrasonographic enthesitis is associated with impaired quality of life in axial SpA. MASEI 1 and 2 is spesific entheseal regions in MASEI index for axial SpA. We should focus on the calcaneal enthesit region for clinical investigation and ultrasonographic enthesopathy in axial SpA different from RA. KEYWORDS: enthesitis, enthesopathy, rheumatoid arthiritis, spondyloarthropathy, ultrasound.