title: Enthesis inflammation in recurrent acute anterior uveitis without spondylarthritis.
abstract: OBJECTIVE
  To investigate whether patients with idiopathic recurrent acute anterior uveitis (AAU) have enthesis alterations comparable with those in patients with spondylarthritis (SpA).
  
  
  METHODS
  A blinded, controlled study of enthesis evident on ultrasound (US) examination was performed in 100 patients and controls classified into 5 groups, as follows: patients with confirmed SpA (group 1), patients with recurrent AAU who were positive for HLA-B27 and did not have SpA (group 2), patients with recurrent AAU who were negative for HLA-B27 and did not have SpA (group 3), patients with forms of uveitis other than those related to SpA (group 4), and healthy controls (group 5). In total, 12 enthesis locations were explored in each patient and control subject by 2 ultrasonographers who were blinded with regard to the diagnosis. A newly developed US method, the Madrid Sonography Enthesitis Index (MASEI), in which the diagnosis of SpA is determined as a cutoff score of 18 points, was used.
  
  
  RESULTS
  A total of 1,200 entheses were explored by US in 100 patients and controls. The MASEI cutoff limit was met or exceeded by 81%, 55.6%, 40%, 10%, and 19% of the subjects in the 5 groups, respectively. The MASEI score was significantly higher in groups 1 and 2 than in groups 4 and 5. The differences between groups 1 and 3 were also found to be significant.
  
  
  CONCLUSIONS
  Our findings indicate that a high percentage of HLA-B27-positive patients with idiopathic recurrent AAU without features of SpA have enthesis lesions comparable with those seen in patients with SpA. These data suggest that patients with recurrent AAU, especially those who are HLA-B27 positive, have an abortive or incomplete form of SpA.
authors: Hospital Universitario La Paz, Madrid, Spain. santiago.munoz@salud.madrid.org
authors: Santiago
authors: S
authors: Muñoz-Fernández
authors: Eugenio
authors: E
authors: de Miguel
authors: Tatiana
authors: T
authors: Cobo-Ibáñez
authors: Rosario
authors: R
authors: Madero
authors: Antonio
authors: A
authors: Ferreira
authors: M Ventura
authors: MV
authors: Hidalgo
authors: Armelle
authors: A
authors: Schlincker
authors: Emilio
authors: E
authors: Martín-Mola
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D015796:HLA-B27 Antigen / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012216:Rheumatic Diseases / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D016037:Single-Blind Method; D025241:Spondylarthritis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000276:immunology; D018608:Ultrasonography, Doppler; D014606:Uveitis, Anterior / Q000150:complications* / Q000000981:diagnostic imaging* / Q000276:immunology; D055815:Young Adult
chemical_list: D015796:HLA-B27 Antigen