The relationship between physical examination and ultrasonography for large entheses is best for the Achilles tendon and patellar tendon origin

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 (hypoechogenicity (p<0.001), thickening (p=0.01), Doppler (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 ultrasound.

Conclusion: The relationship between clinical and sonographic findings for large entheses is dependent on the anatomical site and is best for the Achilles tendon and patellar tendon origin.