Presence of enthesopathy demonstrated with ultrasonography in systemic sclerosis.
OBJECTIVE
The aim of this study was to sonographically assess the presence and distribution of enthesopathy in systemic sclerosis (SSc).


METHODS
Consecutive patients with SSc and age-matched healthy controls were included in this study. All of the patients met the 2013 American College of Rheumatology/European League Against Rheumatism classification criteria for SSc. Six entheses sites were evaluated using gray scale and Doppler ultrasonographies (USs) with a linear transducer and were scored using the Madrid Sonography Enthesitis Index (MASEI).


RESULTS
We evaluated 52 patients with SSc (46.10 ± 13.42 years) and 41 healthy controls (49.59 ± 9.35 years). Patients with SSc had significantly higher MASEI scores than the healthy controls. Except for plantar aponeurosis, the tendons and ligaments were thicker in the SSc group. In the SSc group, there were 25 (48.1%) diffuse cutaneous SScs and 22 (42.3%) limited cutaneous SScs. Variables such as age, BMI, disease duration, diagnostic delay and MASEI scores were similar in subgroups of SSc. There was a positive correlation between MASEI score and age, modified Rodnan's skin score and dyspnea grade, and a negative correlation with handgrip strength.


CONCLUSIONS
To the best of our knowledge, this is the first study showing the presence of enthesopathy in patients with SSc using US. Enthesopathy should be kept in mind in symptomatic patients with SSc; additionally, it can be easily identified with US.
a Division of Rheumatology, Department of Physical Medicine and Rehabilitation , Faculty of Medicine, Erciyes University , Kayseri , Turkey.
Erkan
E
Kilic
Gamze
G
Kilic
Ozgur
O
Akgul
Salih
S
Ozgocmen
D000293:Adolescent; D000328:Adult; D000368:Aged; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012216:Rheumatic Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D012595:Scleroderma, Systemic / Q000150:complications* / Q000175:diagnosis; D013710:Tendons / Q000000981:diagnostic imaging*; D018608:Ultrasonography, Doppler / Q000379:methods*; D055815:Young Adult
Doppler; Enthesitis; Enthesopathy; Systemic sclerosis; Ultrasonography