The Relationship Between Physical Examination and Ultrasonography of Large Entheses of the Achilles Tendon and Patellar Tendon Origin

Sibel Zehra Aydin; Sibel Bakirci; Esen Kasapoglu; Concepcion Castillo-Gallego; Fatıma Arslan Alhussain; Zoe R. Ash; Esra Kurum; Dennis McGonagle; Helena Marzo-Ortega; Dafna Gladman; Lihi Eder

doi:10.3899/jrheum.190169

Abstract

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 (US): hypoechogenicity, p < 0.001; thickening, p = 0.001; Doppler signals, 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 US.

Conclusion. The relationship between clinical and sonographic findings for large entheses is dependent on the anatomical site. For the patellar tendon origin and Achilles entheses, PE is significantly linked to US findings.

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Footnotes

This research is supported by the NIHR Leeds Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the UK National Health Service, the NIHR, or the UK Department of Health.