title: The role of biomechanical factors and HLA-B27 in magnetic resonance imaging-determined bone changes in plantar fascia enthesopathy.
abstract: 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.
authors.affiliation: Rheumatology and Rehabilitation Research Unit, University of Leeds, 36 Clarendon Road, Leeds LS2 9NZ, UK. d.g.mcgonagle@leeds.ac.uk
authors.forename: Dennis
authors.initials: D
authors.lastname: McGonagle
authors.forename: Helena
authors.initials: H
authors.lastname: Marzo-Ortega
authors.forename: Philip
authors.initials: P
authors.lastname: O'Connor
authors.forename: Wayne
authors.initials: W
authors.lastname: Gibbon
authors.forename: Colin
authors.initials: C
authors.lastname: Pease
authors.forename: Richard
authors.initials: R
authors.lastname: Reece
authors.forename: Paul
authors.initials: P
authors.lastname: Emery
mesh_terms: 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
chemical_list: D015796:HLA-B27 Antigen