title: The occurrence of lower limb enthesopathy in coeliac disease patients without clinical signs of articular involvement.
abstract: OBJECTIVE
  Coeliac disease (CD) is a systemic autoimmune condition induced by gluten consumption in genetically predisposed people, affecting ∼1% of the general population. In the literature, there are many studies that report the association between CD and different kinds of arthritis. The aim of this study was to investigate the presence of entheseal abnormalities by US in patients with CD without clinical signs of articular involvement as compared with healthy control subjects.
  
  
  METHODS
  Sixty patients with CD attending the gastroenterology outpatient clinic of the University Federico II of Naples and 60 healthy control subjects matched for age and sex were enrolled in this study. Coeliac patients and healthy controls underwent clinical and US examination.
  
  
  RESULTS
  Among 60 CD patients, 24 (40%) presented at least one entheseal alteration as compared with 6 (10%) control subjects (P < 0.01). In CD patients, the entheseal site more frequently involved was patellar (distal and proximal), while in the healthy controls the enthesopathies were all localized at the Achilles tendon.
  
  
  CONCLUSIONS
  In conclusion, the results of this study underline the ability of US to detect signs of subclinical enthesopathy and indicate the presence of a higher prevalence of subclinical enthesopathies in asymptomatic CD patients.
authors.affiliation: Rheumatology Research Unit, Department of Clinical and Experimental Medicine, University Federico II of Naples, via S. Pansini 5, 80131 Naples, Italy. m.atteno@alice.it
authors.forename: Mariangela
authors.initials: M
authors.lastname: Atteno
authors.forename: Luisa
authors.initials: L
authors.lastname: Costa
authors.forename: Raffaella
authors.initials: R
authors.lastname: Tortora
authors.forename: Antonio
authors.initials: A
authors.lastname: Cozzolino
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Puente
authors.forename: Francesco
authors.initials: F
authors.lastname: Caso
authors.forename: Paolo
authors.initials: P
authors.lastname: Sfriso
authors.forename: Raffaele
authors.initials: R
authors.lastname: Scarpa
authors.forename: Carolina
authors.initials: C
authors.lastname: Ciacci
mesh_terms: D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007558:Italy; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D012216:Rheumatic Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000276:immunology; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D018608:Ultrasonography, Doppler; D055815:Young Adult