title: Heel pain in spondyloarthritis: results of a cross-sectional study of 275 patients.
abstract: OBJECTIVE
  Heel pain is a common but poorly studied feature of spondyloarthritis (SpA). The aims of this study were to assess the prevalence and clinical features of heel pain in a cohort of patients with SpA.
  
  
  METHODS
  This was a retrolective single centre observational study in 2010. Patients with SpA as defined by Amor's criteria were recruited. The data collected were: demographic and disease characteristics, history of heel pain, age at first heel pain, localisation, nature and intensity of pain and treatments. The analyses were descriptive.
  
  
  RESULTS
  A total of 275 SpA patients (mean age 44.6±13.5 yrs, mean disease duration 16.7±11.8 yrs, 61.5% men) were assessed. A history of heel pain was reported in 130 patients (47.1%), and was the first symptom of SpA in 15.7% of all patients. Heel pain was frequent in both axial (89/201, 44.3%) and peripheral disease (27/56, 48.2%). Distribution was more frequently inferior (88, 69.3%) than posterior (61, 48.0%) (p<0.0001), and frequently bilateral: simultaneously (41.9%) rather than alternatively (29.1%) (p=0.03). Main clinical symptoms were: morning pain on weight bearing (83.6%), but also night pain (34.4%), and/or patient-described swelling (24.2%). Heel pain was frequently recurrent (74.2%), intense (70.3%), source of a limp (71.6%), and often resistant to non-steroidal anti-inflammatory drugs (NSAIDs) (54/108, 50%). Tumour necrosis factor blockers were efficacious on heel pain in 72/94 (76.6%) of cases.
  
  
  CONCLUSIONS
  This study confirmed heel pain as a frequent symptom in both axial and peripheral SpA. It occurred early in the disease course and it was frequently recurrent and resistant to NSAIDs.
authors.affiliation: Paris-Descartes University, Rheumatology B Department, Paris, France. koumakis@hotmail.com
authors.forename: Eugénie
authors.initials: E
authors.lastname: Koumakis
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
authors.forename: Muriel
authors.initials: M
authors.lastname: Elhai
authors.forename: Vincent
authors.initials: V
authors.lastname: Burki
authors.forename: Anne
authors.initials: A
authors.lastname: Durnez
authors.forename: Isabelle
authors.initials: I
authors.lastname: Fabreguet
authors.forename: Magali
authors.initials: M
authors.lastname: Meyer
authors.forename: Judith
authors.initials: J
authors.lastname: Payet
authors.forename: Fanny
authors.initials: F
authors.lastname: Roure
authors.forename: Simon
authors.initials: S
authors.lastname: Paternotte
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D018771:Arthralgia / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006365:Heel / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D025241:Spondylarthritis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha