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2019•The Journal of RheumatologyOpen access

The Relationship Between Physical Examination and Ultrasonography of Large Entheses of the Achilles Tendon and Patellar Tendon Origin

Sibel Zehra Aydın, Sibel Bakırcı, Esen Kasapoglu, Concepción Castillo-Gallego, Fatıma Arslan Alhussain, Zoe R. Ash, Esra Kürüm, Dennis McGonagle, Helena Marzo‐Ortega, Dafna D. Gladman, Lihi Eder

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Abstract

OBJECTIVE: To investigate the relationship between physical examination (PE) and sonographic features of enthesitis, based on anatomical sites. METHODS: The analysis was done using merged raw data of 3 studies on 2298 entheses. RESULTS: Patients with clinical Achilles enthesitis had more abnormalities on ultrasound (US): hypoechogenicity, p < 0.001; thickening, p = 0.001; Doppler signals, p = 0.002; and erosions, p = 0.02. The patellar tendon origin also correlated with PE but distal patellar tendon insertion and plantar aponeurosis were uncoupled from the US. CONCLUSION: The relationship between clinical and sonographic findings for large entheses is dependent on the anatomical site. For the patellar tendon origin and Achilles entheses, PE is significantly linked to US findings.

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OBJECTIVE: To investigate the relationship between physical examination (PE) and sonographic features of enthesitis, based on anatomical sites. METHODS: The analysis was done using merged raw data of 3 studies on 2298 entheses. RESULTS: Patients with clinical Achilles enthesitis had more abnormalities on ultrasound (US): hypoechogenicity, p < 0.001; thickening, p = 0.001; Doppler signals, p = 0.002; and erosions, p = 0.02. The patellar tendon origin also correlated with PE but distal patellar tendon insertion and plantar aponeurosis were uncoupled from the US. CONCLUSION: The relationship between clinical and sonographic findings for large entheses is dependent on the anatomical site. For the patellar tendon origin and Achilles entheses, PE is significantly linked to US findings.

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Available abstract

OBJECTIVE: To investigate the relationship between physical examination (PE) and sonographic features of enthesitis, based on anatomical sites. METHODS: The analysis was done using merged raw data of 3 studies on 2298 entheses. RESULTS: Patients with clinical Achilles enthesitis had more abnormalities on ultrasound (US): hypoechogenicity, p < 0.001; thickening, p = 0.001; Doppler signals, p = 0.002; and erosions, p = 0.02. The patellar tendon origin also correlated with PE but distal patellar tendon insertion and plantar aponeurosis were uncoupled from the US. CONCLUSION: The relationship between clinical and sonographic findings for large entheses is dependent on the anatomical site. For the patellar tendon origin and Achilles entheses, PE is significantly linked to US findings.

Key concepts: Enthesis, Achilles tendon, Aponeurosis, Enthesitis, Medicine, Tendon, Ultrasound, Patellar tendon

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