RT Journal Article
SR Electronic
T1 Power Doppler Ultrasonography Assessment of Entheses in Spondyloarthropathies: Response to Therapy of Entheseal Abnormalities
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 2110
OP 2117
DO 10.3899/jrheum.100136
VO 37
IS 10
A1 ESPERANZA NAREDO
A1 ENRIQUE BATLLE-GUALDA
A1 M. LUZ GARCÍA-VIVAR
A1 ANGEL M. GARCÍA-APARICIO
A1 JOSE LUIS FERNÁNDEZ-SUEIRO
A1 MANUEL FERNÁNDEZ-PRADA
A1 EMILIO GINER
A1 MANUEL RODRIGUEZ-GOMEZ
A1 MARIA FRANCISCA PINA
A1 JULIO A. MEDINA-LUEZAS
A1 FRANCISCO JAVIER TOYOS
A1 CRISTINA CAMPOS
A1 RICARDO GUTIÉRREZ-POLO
A1 MIGUEL ANGEL FERRER
A1 OLGA MARTÍNEZ
A1 CESAR DÍAZ-TORNE
A1 TERESA GONZALEZ
A1 SERAFÍN CAMPOS
A1 RUBÉN QUEIRO
A1 MANUEL CASTAÑO-SÁNCHEZ
A1 JUAN JOSÉ AZNAR
A1 SAGRARIO BUSTABAD
A1 MANUEL PAEZ-CAMINO
A1 ROSER TUNEU
A1 TERESA RUIZ
A1 LOURDES MATEO
A1 MANUEL PUJOL
A1 ANDRÉS PONCE
A1 INMACULADA ROS
A1 ANGEL GALLEGOS
A1 JUAN MORENO
A1 DOMINGO GUMBAU
A1 MANUELA SIANES
A1 M. JOSE POVEDA-ELICES
A1 MONTSERRAT ROMERO-GÓMEZ
A1 ENRIQUE RAYA
YR 2010
UL http://www.jrheum.org/content/37/10/2110.abstract
AB Objective. To investigate the response to therapy of entheseal abnormalities assessed with power Doppler (PD) ultrasound (US) in spondyloarthropathies (SpA). Methods. A total of 327 patients with active SpA who were starting anti-tumor necrosis factor (TNF) therapy were prospectively recruited at 35 Spanish centers. A PDUS examination of 14 peripheral entheses was performed by the same investigator in each center at baseline and at 6 months. The following elementary lesions were assessed at each enthesis (presence/absence): morphologic abnormalities (hypoechogenicity and/or thickening), entheseal calcific deposits, cortical abnormalities (bone erosion and/or proliferation), adjacent bursitis and intraenthesis and perienthesis (tendon body and/or bursa) PD signal. Response to therapy of each elementary lesion was assessed by calculating change in the cumulative presence from baseline to 6 months. Intraobserver reliability of PDUS was evaluated by blindly assessing the stored baseline images 3 months after the real-time examination. Results. Complete data were obtained on 197 patients who received anti-TNF therapy for 6 months. In 91.4% of the patients there were gray-scale or PD elementary lesions at baseline and at 6 months. Cumulative entheseal morphologic abnormalities, intraenthesis PD, perienthesis PD, and bursitis showed a significant decrease from baseline to 6 months (p < 0.05). There was high intraobserver reliability for all elementary lesions (interclass correlation coefficient > 0.90, p < 0.0005). Conclusion. Entheseal morphologic abnormalities, PD signal, and bursitis were US abnormalities that were responsive to anti-TNF therapy in SpA. PDUS can be a reproducible method for multicenter monitoring of therapeutic response in enthesitis of SpA.