Di Matteo, A., Smerilli, G., Di Donato, S. et al. (46 more authors) (2024) Power Doppler signal at the enthesis and bone erosions are the most discriminative OMERACT ultrasound lesions for SpA: results from the DEUS (Defining Enthesitis on Ultrasound in Spondyloarthritis) multicentre study. Annals of the Rheumatic Diseases, 83 (7). pp. 847-857. ISSN 0003-4967
Abstract
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.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | Biomedical and Clinical Sciences; Oncology and Carcinogenesis; Clinical Research; Biomedical Imaging; Arthritis; Aging; Evaluation of markers and technologies; Humans; Female; Male; Enthesopathy; Adult; Middle Aged; Ultrasonography, Doppler; Spondylarthritis; Arthritis, Psoriatic; Severity of Illness Index; Achilles Tendon; Case-Control Studies |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Inflammatory Arthritis (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Musculoskeletal Disease (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 13 Aug 2024 12:09 |
Last Modified: | 13 Aug 2024 12:09 |
Published Version: | http://dx.doi.org/10.1136/ard-2023-225443 |
Status: | Published |
Publisher: | BMJ |
Identification Number: | 10.1136/ard-2023-225443 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:215965 |