The role of biomechanical factors and HLA-B27 in magnetic resonance imaging-determined bone changes in plantar fascia enthesopathy.
OBJECTIVE
To study the role of biomechanical factors and HLA-B27 in plantar fasciitis.


METHODS
T1-weighted and T2 spectral presaturation with inversion recovery (fat suppressed) magnetic resonance imaging (MRI) sequences of the plantar fascia insertion and adjacent bone were performed on 28 patients with plantar fasciitis; 17 had spondylarthropathy (SpA)-associated disease, and 11 had mechanically induced disease. The relationship between the degree of bone edema, scored on a semiquantitative scale (from absent to severe), and the patient's HLA-B27 status was determined.


RESULTS
On MRI, edema within the soft tissue at the enthesis was evident in both groups. Bone edema in the adjacent calcaneum was evident in 64.7% (11 of 17) of patients with SpA and in 45% (5 of 11) of those with mechanically induced disease (P = 0.441). HLA-B27 was identified in 9 (53%) of the patients with SpA but in none (0%) of those with mechanically induced disease. All 6 of the SpA patients with extensive bone edema but none of the 5 SpA patients with mild bone edema were HLA-B27 positive (P = 0.002).


CONCLUSIONS
The association of HLA-B27 with bone pathology in early enthesitis may have implications for a better understanding of the pathogenesis of SpA.
McGonagle
Dennis
D
Rheumatology and Rehabilitation Research Unit, University of Leeds, 36 Clarendon Road, Leeds LS2 9NZ, UK. d.g.mcgonagle@leeds.ac.uk
Marzo-Ortega
Helena
H
O'Connor
Philip
P
Gibbon
Wayne
W
Pease
Colin
C
Reece
Richard
R
Emery
Paul
P
D000125:Achilles Tendon / Q000293:injuries / Q000473:pathology; D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D002111:Calcaneus / Q000293:injuries / Q000473:pathology*; D004487:Edema / Q000235:genetics / Q000473:pathology; D005205:Fascia / Q000293:injuries / Q000473:pathology; D005208:Fasciitis / Q000235:genetics / Q000473:pathology*; D005260:Female; D015796:HLA-B27 Antigen / Q000235:genetics*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D025242:Spondylarthropathies / Q000235:genetics / Q000473:pathology*; D052256:Tendinopathy / Q000235:genetics / Q000473:pathology
D015796:HLA-B27 Antigen