title: Spectrum of ultrasound pathologies of achilles tendon, plantar aponeurosis and flexor digiti brevis tendon heel entheses in patients with clinically suspected enthesitis.
abstract: BACKGROUND
  Enthesitis is considered a characteristic presentation of the second most common group of rheumatoid disorders, i.e. spondyloarthropathies (SpAs), particularly peripheral spondyloarthropathies. At the initial stages, enthesitis may be the only symptom of SpA, particularly in patients lacking the HLA-B27 receptor.
  
  
  METHODS
  In light of diagnostic difficulties with detecting enthesitis in clinical examinations and laboratory investigations, many studies point out the high specificity of imaging studies, and particularly ultrasonography.
  
  
  RESULTS
  A total of 20% Achilles tendon entheses, 45% plantar aponeurosis entheses and 89.5% of flexor digiti brevis tendon entheses were unremarkable. In the remaining cases, the presentation of pathological lesions was not specific to enthesitis and might more likely correspond to degeneration or microinjuries of the entheses, beside the most obvious cases of achillobursitis or Kager's fat pad inflammation.
  
  
  CONCLUSIONS
  The studies demonstrated that ultrasound scans rarely confirm the clinical diagnosis of enthesitis.
authors: Department of Radiology, Institute of Rheumatology, Warsaw, Poland ; Department of Diagnostic Imaging, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.
authors: Iwona
authors: I
authors: Sudoł-Szopińska
authors: Department of Radiology, Institute of Rheumatology, Warsaw, Poland.
authors: Katarzyna
authors: K
authors: Zaniewicz-Kaniewska
authors: Early Arthritis Clinic, Institute of Rheumatology, Warsaw, Poland.
authors: Brygida
authors: B
authors: Kwiatkowska
keywords: Achilles Tendon; Doppler; Rheumatic Diseases; Ultrasonography