AB0876 Can ultrasonographic peripheral enthesitis mirror spinal radiographic abnormalities and other disease parameters in patients radiographic axial SpA?

Abstract

BackgroundAlthough enthesitis is the hallmark of spondyloarthritides, the association between peripheral enthesitis, radiographic spinal affection and disease assessment parameters is still underestimated.ObjectivesIn this cross-sectional prospective study, we aimed to evaluate the relation of US pattern of peripheral enthesitis with the spinal radiographic changes and other disease parameters in patients with radiographic axial spondyloarthritis (SpA).MethodsFifty-eight patients with radiographic axial SpA (ASAS criteria) were studied for the presence and pattern of peripheral lower limb enthesitis according to the Outcome Measures in Rheumatology (OMERACT) US definitions: Achilles tendon, plantar fascia, proximal and distal patellar ligaments, and quadriceps tendon insertions. The findings then were correlated with the radiographic spinal abnormalities, Bath AS radiographic index (BASRI), Bath AS disease activity index (BASDAI), Bath AS functional index (BASFI), and Bath AS metrology index (BASMI) together with the HLA-B27 status and inflammatory markers using Spearmann rho correlation co-efficient.ResultsThe mean age was 37.96 (±13.1) years, 75.86% were males. Thirty-six patients (62%) had US enthesitis (USE) with a mean age of 39.2 (±12.8). HLA-B27 was positive in 61% of patients with USE and 54.5% in those without. There was no difference between patients with and without USE regarding the disease duration, age at onset but those with USE showed less diagnostic delay (p = 0.03). Clinical enthesitis and peripheral arthritis were more frequent in those with USE (50% vs 22.7% and 25% vs 13.6% respectively). No statistical significant difference has been found between the inflammatory, structural and total scores of USE and BASRI, BASFI and BASDAI (p > 0.05). No correlation could be detected between BASRI and USE scores (rs= 0.12, p =0.45 for inflammatory, rs=0.25, p=0.11 for structural and rs=0.18, p=0.28 for total score). There was a positive correlation between BASMI and both inflammatory and total scores of USE (rs= 0.485, p=0.003). No significant association between BASDAI, CRP or ESR and USE scores.ConclusionUltrasonographic peripheral entheseal abnormalities couldn’t reflect the spinal radiographic changes or disease assessment parameters in patients with radiographic axial SpA. However, these results can be considered preliminary and more studies on wider scales are needed to support our findings.Disclosure of InterestsAbdelhfeez Moshrif Speakers bureau: Amgen, Jansen, Novartis, Mohamed Ismail Abdelkareem Speakers bureau: Abbvie, Jansen, Novartis and Organon, Sonya Rashad: None declared, Ahmed Negm: None declared, Ahmed Mosallam Speakers bureau: Amgen, Pfizer and Novartis, Hassan Bassiouni Speakers bureau: Abbvie, Jansen, Novartis, and MSD