Histological assessment of the early enthesitis lesion in spondyloarthropathy.
OBJECTIVE
To describe the histological changes in acute enthesopathy in early spondyloarthropathies (SpA).


METHODS
Clinically evident acute enthesopathy was confirmed by magnetic resonance imaging and ultrasonography in four cases of plantar fasciitis and one case of patellar tendon enthesitis. Ultrasound guided biopsy of insertional points was carried out with a Jamshedi needle. Control tissue was obtained from two subjects undergoing spinal grafting surgery. Standard histochemistry and immunohistochemistry analysis using the avidin-biotin immunoperoxidase complex method employing markers against CD3, CD8, CD34, and CD68 was used to determine cellular infiltrates at the insertion point.


RESULTS
The enthesis architecture was abnormal in the SpA group, with increased vascularity and cellular infiltration compared with normal subjects. The predominant infiltrating cell at the enthesis fibrocartilage was the macrophage, but there was a paucity of lymphocytes at the insertion point.


CONCLUSIONS
These preliminary findings have implications for a better understanding of the pathology in early SpA.
McGonagle
D
D
Rheumatology and Rehabilitation Research Unit, University of Leeds, 36 Clarendon Road, Leeds LS2 9NZ, UK. d.g.mcgonagle@leeds.ac.uk
Marzo-Ortega
H
H
O'Connor
P
P
Gibbon
W
W
Hawkey
P
P
Henshaw
K
K
Emery
P
P
D000328:Adult; D001706:Biopsy / Q000379:methods; D005355:Fibrosis; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008264:Macrophages / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D025242:Spondylarthropathies / Q000473:pathology*; D052256:Tendinopathy / Q000473:pathology*