Subclinical enthesitis in enthesitis-related arthritis and sacroiliitis associated with familial Mediterranean fever

ŞENER S., Atalay E., YILDIZ A. E., KASAP CÜCEOĞLU M., BAŞARAN H. Ö., BATU AKAL E. D., ...More

Modern Rheumatology, vol.34, no.3, pp.607-613, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 34 Issue: 3
  • Publication Date: 2024
  • Doi Number: 10.1093/mr/road053
  • Journal Name: Modern Rheumatology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, MEDLINE
  • Page Numbers: pp.607-613
  • Keywords: Enthesitis-related arthritis, familial Mediterranean fever, subclinical enthesitis, tendons, ultrasonography
  • Hacettepe University Affiliated: Yes

Abstract

Objectives: In our study, we investigated the presence of subclinical enthesitis by ultrasonography (US) in asymptomatic patients with enthesitis-related arthritis (ERA) and sacroiliitis associated with familial Mediterranean fever (FMF). Methods: A total of 50 patients, including 35 patients with ERA and 15 with sacroiliitis associated with FMF, were included in the study. All patients were evaluated with US by a paediatric radiologist. Enthesis of seven tendons (common extensor and flexor tendons, quadriceps tendon, proximal and distal patellar tendon, Achilles tendon, and plantar fascia) was examined on both sides. Results: Subclinical enthesitis was detected in 10 ERA (28.5%) and three FMF (20%) patients. Enthesitis was radiologically diagnosed in 16 (2.3%) out of 700 evaluated entheseal sites. The most frequent sites of enthesitis were Achilles (37.5%) and quadriceps (31.3%) tendons. All patients were in clinical remission and had no active complaints, and acute phase reactants were within normal limits. Therefore, the patients were followed up without treatment change. However, disease flare-up was observed in three of these patients (23.1%) during the follow-up, and their treatments were intensified. Conclusions: Our results showed that the US can be particularly helpful in detecting subclinical enthesitis and predicting disease flare-ups.