- Visibility 363 Views
- Downloads 315 Downloads
- Permissions
- DOI 10.18231/j.ijor.2025.006
-
CrossMark
- Citation
Association of enthesopathy among patients diagnosed with Rheumatoid arthritis
- Author Details:
-
Chinmoy Das
-
Partha Pratim Das
-
Kaushik Bharali
-
Imran Hussain *
Aim & Objective: The purpose of this study was to use ultrasonography at Tezpur Medical College and Hospital in Assam to assess the prevalence and distribution of enthesopathy in RA patients.
Background: Rheumatoid arthritis (RA) is a widely occurring autoimmune disorder that primarily targets the synovial membranes of small joints. However, it can also present with symptoms outside the joints. One such symptom, enthesopathy, is often difficult to diagnose clinically. Ultrasonography has emerged as a newer technique for identifying enthesopathy.
Materials and Methods: There were 14 healthy controls and 29 RA patients in the study. Six entheses sites were graded using the Madrid Sonography Enthesitis Index (MASEI) and analyzed using Doppler ultrasound and a linear transducer in order to evaluate enthesopathy.
Results: Enthesopathy in RA patients was successfully identified by ultrasonography. The enthesopathy scores at the plantar aponeurosis and Achilles tendon insertions showed statistically significant variations. Compared to healthy controls, RA patients had a significantly higher overall enthesopathy score.
Conclusion: Enthesal abnormalities were shown to be highly prevalent in RA patients assessed by ultrasonography.
Keywords: Rheumatoid arthritis, Enthesitis, Ultrasonography, Enthesopathy.
References
- Eshed I, Bollow M, McGonagle DG, Tan AL, Althoff CE, Asbach P, et al. MRI of enthesitis of the appendicular skeleton in spondyloarthritis. Ann Rheum Dis. 2007;66(12):1553–9.
- Alvarez A, Tiu TK. Enthesopathies. [Updated 2023 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan -. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559030
- Araujo EG, Schett G. Enthesitis in psoriatic arthritis (Part 1): pathophysiology. Rheumatology (Oxford). 2020;59(Suppl 1):i10–4.
- Turesson C. Extra-articular rheumatoid arthritis. Curr Opin Rheumatol. 2013;25(3):360–6.
- Terslev L, Naredo E, Iagnocco A, Balint PV, Wakefield RJ, Aegerter P, et al. Defining enthesitis in spondyloarthritis by ultrasound: results of a Delphi process and of a reliability reading exercise. Arthritis Care Res. 2014;66(5):741–8.
- De Miguel E, Cobo T, Muñoz-Fernández S, Naredo E, Usón J, Acebes JC, et al. Validity of enthesis ultrasound assessment in spondyloarthropathy. Ann Rheum Dis. 2009;68(2):169–74.
- Gandjbakhch F, Conaghan PG, Ejbjerg B, Haavardsholm EA, Foltz V, Brown AK, et al. Synovitis and osteitis are very frequent in rheumatoid arthritis clinical remission: results from an MRI study 42 Das et al / IP International Journal of Orthopaedic Rheumatology 2025;11(1):38-42 of 294 patients in clinical remission or low disease activity state. J Rheumatol. 2011;38(9):2039–44.
- D’Agostino MA, Aegerter P, Bechara K, Salliot C, Judet O, Chimenti MS, et al. How to diagnose spondyloarthritis early? Accuracy of peripheral enthesitis detection by power Doppler ultrasonography. Ann Rheum Dis. 2011;70(8):1433–40.
- Kay J, Upchurch KS. ACR/EULAR 2010 rheumatoid arthritis classification criteria. Rheumatology. 2012;51:vi5–vi9.
- Prevoo M, van’T Hof MA, Kuper H, van Leeuwen M, van De Putte L, van Riel P. Modified disease activity scores that include twenty- eightjoint counts development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995;38(1):44–8.
- Scutellari PN, Orzincolo C. Rheumatoid arthritis: sequences. Eur J Radiol. 1998;27(Suppl 1):S31–8.
- Bicer A. Musculoskeletal findings in Behcet’s disease. Patholog Res Int. 2012;2012:653806
- Michelsen B, Diamantopoulos AP, Soldal DM, Hammer HB, Kavanaugh A, Haugeber G. Achilles enthesitis defined by ultrasound is not associated with clinical enthesitis in patients with psoriatic arthritis. RMD Open. 2017;3:e000486.
- Balint P, Kane D, Wilson H, McInnes I, Sturrock R. Ultrasonography of entheseal insertions in the lower limb in spondyloarthropathy. Ann Rheum Dis. 2002;61(10):905–10.
- McGonagle D, Hermann K-GA, Tan AL. Differentiation between osteoarthritis and psoriatic arthritis: implications for pathogenesis and treatment in the biologic therapy era. Rheumatology. 2015;54(1):29–38.
- Sudo1-Szopionska I, Kwiatkowska B, Prochorec-Sobieszek M, Pracoń G, Walentowska-Janowicz M, Maśliński W, et al. Enthesopathies and enthesitis. Part 2: Imaging studies. J Ultrason. 2015;15(61):196–207.
- Sudo1-Szopionska I, Kwiatkowska B, Prochorec-Sobeszek M, Maśliński W. Enthesopathies and enthesitis. Part 1. Etiopathogenesis. J Ultrason. 2015;15(60):72–84
- McGonagle D, Stockwin L, Isaacs J, Emery P. An enthesitis based model for the pathogenesis of spondyloartropathy additive effects of microbial adjuvant and biomechanical factors at diseases sites. J Rheumatol. 2001;28(10):2155–9.
- Jacques P, Lambrecht S, Verheugen E, Pauwels E, Kollias G, Armaka M, et al. Proof of concept: enthesitis and new bone formation in SpA are driven by mechanical strain and stromal cells. Ann Rheum Dis. 2014;73(2):437–45.
- Boutry N, Morel M, Flipo RM, Demondion X, Cotten A. Early rheumatoid arthritis: a review of MRI and sonographic findings. AJR Am J Roentgenol. 2007;189(6):1502–9
- Feydy A, Lavie-Bryon MC, Gossec L, Lavie F, Guerini H, Nguyen C, et al. Comparative study of MRI and power Doppler ultrasonography of the heel in patients with spondyloarthritis with and without heel pain and in controls. Ann Rheum Dis. 2012;71(14):498–503
How to Cite This Article
Vancouver
Das C, Das PP, Bharali K, Hussain I. Association of enthesopathy among patients diagnosed with Rheumatoid arthritis [Internet]. IP Int J Orthop Rheumatol. 2025 [cited 2025 Oct 17];11(1):38-42. Available from: https://doi.org/10.18231/j.ijor.2025.006
APA
Das, C., Das, P. P., Bharali, K., Hussain, I. (2025). Association of enthesopathy among patients diagnosed with Rheumatoid arthritis. IP Int J Orthop Rheumatol, 11(1), 38-42. https://doi.org/10.18231/j.ijor.2025.006
MLA
Das, Chinmoy, Das, Partha Pratim, Bharali, Kaushik, Hussain, Imran. "Association of enthesopathy among patients diagnosed with Rheumatoid arthritis." IP Int J Orthop Rheumatol, vol. 11, no. 1, 2025, pp. 38-42. https://doi.org/10.18231/j.ijor.2025.006
Chicago
Das, C., Das, P. P., Bharali, K., Hussain, I.. "Association of enthesopathy among patients diagnosed with Rheumatoid arthritis." IP Int J Orthop Rheumatol 11, no. 1 (2025): 38-42. https://doi.org/10.18231/j.ijor.2025.006