TY - JOUR
T1 - Power Doppler signal at the enthesis and bone erosions are the most discriminative OMERACT ultrasound lesions for SpA
T2 - Results from the DEUS (Defining Enthesitis on Ultrasound in Spondyloarthritis) multicentre study
AU - Di Matteo, Andrea
AU - Smerilli, Gianluca
AU - Di Donato, Stefano
AU - Liu, An Ran
AU - Becciolini, Andrea
AU - Camarda, Federica
AU - Cazenave, Tomas
AU - Cipolletta, Edoardo
AU - Corradini, Davide
AU - De Agustín, Juan José
AU - Destro Castaniti, Giulia Maria
AU - Di Donato, Eleonora
AU - Di Geso, Luca
AU - Duran, Emine
AU - Farisogullari, Bayram
AU - Fornaro, Marco
AU - Francioso, Francesca
AU - Giorgis, Pamela
AU - Granel, Amelia
AU - Hernández-Díaz, Cristina
AU - Horvath, Rudolf
AU - Hurnakova, Jana
AU - Jesus, Diogo
AU - Karadag, Omer
AU - Li, Ling
AU - Marin, Josefina
AU - Martire, María Victoria
AU - Michelena, Xabier
AU - Moscioni, Erica
AU - Muntean, Laura
AU - Piga, Matteo
AU - Rosemffet, Marcos
AU - Rovisco, João
AU - Sahin, Didem
AU - Salaffi, Fausto
AU - Saraiva, Liliana
AU - Scioscia, Crescenzio
AU - Tamas, Maria Magdalena
AU - Tanimura, Shun
AU - Venetsanopoulou, Aliki
AU - Ventura-Rios, Lucio
AU - Villota, Orlando
AU - Villota-Eraso, Catalina
AU - Voulgari, Paraskevi V.
AU - Vukatana, Gentiana
AU - Zacariaz Hereter, Johana
AU - Marzo-Ortega, Helena
AU - Grassi, Walter
AU - Filippucci, Emilio
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ on behalf of EULAR.
PY - 2024/6/12
Y1 - 2024/6/12
N2 - Objectives To assess, in spondyloarthritis (SpA), the discriminative value of the Outcome Measures in Rheumatology (OMERACT) ultrasound lesions of enthesitis and their associations with clinical features in this population. Methods In this multicentre study involving 20 rheumatology centres, clinical and ultrasound examinations of the lower limb large entheses were performed in 413 patients with SpA (axial SpA and psoriatic arthritis) and 282 disease controls (osteoarthritis and fibromyalgia). 'Active enthesitis' was defined as (1) power Doppler (PD) at the enthesis grade ≥1 plus entheseal thickening and/or hypoechoic areas, or (2) PD grade >1 (independent of the presence of entheseal thickening and/or hypoechoic areas). Results In the univariate analysis, all OMERACT lesions except enthesophytes/calcifications showed a significant association with SpA. PD (OR=8.77, 95% CI 4.40 to 19.20, p<0.001) and bone erosions (OR=4.75, 95% CI 2.43 to 10.10, p<0.001) retained this association in the multivariate analysis. Among the lower limb entheses, only the Achilles tendon was significantly associated with SpA (OR=1.93, 95% CI 1.30 to 2.88, p<0.001) in the multivariate analyses. Active enthesitis showed a significant association with SpA (OR=9.20, 95% CI 4.21 to 23.20, p<0.001), and unlike the individual OMERACT ultrasound lesions it was consistently associated with most clinical measures of SpA disease activity and severity in the regression analyses. Conclusions This large multicentre study assessed the value of different ultrasound findings of enthesitis in SpA, identifying the most discriminative ultrasound lesions and entheseal sites for SpA. Ultrasound could differentiate between SpA-related enthesitis and other forms of entheseal pathology (ie, mechanical enthesitis), thus improving the assessment of entheseal involvement in SpA.
AB - Objectives To assess, in spondyloarthritis (SpA), the discriminative value of the Outcome Measures in Rheumatology (OMERACT) ultrasound lesions of enthesitis and their associations with clinical features in this population. Methods In this multicentre study involving 20 rheumatology centres, clinical and ultrasound examinations of the lower limb large entheses were performed in 413 patients with SpA (axial SpA and psoriatic arthritis) and 282 disease controls (osteoarthritis and fibromyalgia). 'Active enthesitis' was defined as (1) power Doppler (PD) at the enthesis grade ≥1 plus entheseal thickening and/or hypoechoic areas, or (2) PD grade >1 (independent of the presence of entheseal thickening and/or hypoechoic areas). Results In the univariate analysis, all OMERACT lesions except enthesophytes/calcifications showed a significant association with SpA. PD (OR=8.77, 95% CI 4.40 to 19.20, p<0.001) and bone erosions (OR=4.75, 95% CI 2.43 to 10.10, p<0.001) retained this association in the multivariate analysis. Among the lower limb entheses, only the Achilles tendon was significantly associated with SpA (OR=1.93, 95% CI 1.30 to 2.88, p<0.001) in the multivariate analyses. Active enthesitis showed a significant association with SpA (OR=9.20, 95% CI 4.21 to 23.20, p<0.001), and unlike the individual OMERACT ultrasound lesions it was consistently associated with most clinical measures of SpA disease activity and severity in the regression analyses. Conclusions This large multicentre study assessed the value of different ultrasound findings of enthesitis in SpA, identifying the most discriminative ultrasound lesions and entheseal sites for SpA. Ultrasound could differentiate between SpA-related enthesitis and other forms of entheseal pathology (ie, mechanical enthesitis), thus improving the assessment of entheseal involvement in SpA.
KW - Arthritis, Psoriatic
KW - Fibromyalgia
KW - Osteoarthritis
KW - Spondylitis, Ankylosing
KW - Ultrasonography
UR - https://www.scopus.com/pages/publications/85187685077
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=performanshacettepe&SrcAuth=WosAPI&KeyUT=WOS:001181991400001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1136/ard-2023-225443
DO - 10.1136/ard-2023-225443
M3 - Article
C2 - 38443140
AN - SCOPUS:85187685077
SN - 0003-4967
VL - 83
SP - 847
EP - 857
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
IS - 7
ER -