7/29/2019 Ann Rheum Dis 2010 Sokolik A50

1/2

EWRR abstracts

Ann Rheu m Dis 2010;69(Suppl 2):A1A76A50

A127 EARLY DIAGNOSTIC ACHILLES TENDINOPATHY INPATIENTS WITH PSORIASIS AND ARTHRALGIA

R Sokolik, B Nowak, M Ponikowska, P Wiland Department of Rheumatology and

Interna l Disease, Wroclaw Un iversit y Hospital , Wroclaw, Poland

10.1136/ard.2010.129643d

Background Psoriatic arthritis belongs to a group of spondy-loarthropaties that are characterised by, among other things,enthesopathy. The most typical enthesitis is heel pain relatedto inflammation of the Achilles tendon or the plantar fasciainsertion. Musculoskeletal ultrasonography is a useful tool forevaluating joint and soft tissue pathology and it can be used tovisualise enthesopathy.1,2,3

Objectives The aim of the study was to assess the frequencyof occurrence of Achilles tendinopathy in patients with psori-asis and arthralgia.Methods 33 patients (16 women) aged 2772 years (meanage 49.211.3 years) with psor iasis (mean disease duration20.812.9 years) and arthralgia were enrolled in the study. In27 (82%) patients the diagnosis of psoriatic arthritis (meandisease duration 7.67.1 years) had already been established.Ultrasound (US) examination of the Achil les tendon and pain-ful joints was performed. All examinations were carried outusing a h igh frequency linear transducer (712 MHz, Logiq 5,General Electric). Power Doppler sonography set for high sen-sitivity was used to detect synovium or tendon hyperaemia.Results Only five (15%) patients in our group complained ofachillodynia. In one of them (20%) no pathological changes inthe Achilles tendon were detected. In the remaining four patientswe detected enthesopathy. In 28 patients without achillodynia,US examination of the Achilles tendon region showed Achillestendon oedema in 8 (29%) patients, insertion hyperaemia in 10(36%), erosions in 6 (21%), enthesophytes in 9 (32%) and bursitis

in 8 (29%). During US examination of painful joints in 20 (61%)out of 33 patients, we detected effusion of at least one joint.

Conclusion In 80% of patients with achillodynia, US exam-ination reveals Achilles tendinopathy. In 1/3 patients withpsoriasis and arthralgia but without heel pain, US detectsasymptomatic Achilles tendon enthesopathy. Our results con-firm the sensitivity of US in detecting Achilles tendon enthe-siopathy and its superiority to physical examination.

REFERENCES1. Filippucci E, Iagnocco A, Meenagh G, et al. Ultrasound imaging for the

rheumatologist. Clin Exp Rheumatol2006; 24: 152. Ballint PV, Kane D, Wilson H, et al. Ultrasonography of entheseal insertions in the

lower limb in spondyloarthropathy.Ann Rheum Dis 2002; 61: 90510.

3. DAgostino MA, Said-Nahal R, Hacquard-Bouder U, et al. Assessment of

peripheral enthesitis in the spondyloarthropathies by ultrasonography combined

with power Doppler: a cross-sectional study.Arthr itis Rheum 2003; 48: 52333.

group.bmj.comon September 3, 2013 - Published byard.bmj.comDownloaded from

http://group.bmj.com/http://group.bmj.com/http://group.bmj.com/http://ard.bmj.com/http://ard.bmj.com/http://group.bmj.com/http://ard.bmj.com/

7/29/2019 Ann Rheum Dis 2010 Sokolik A50

2/2

doi: 10.1136/ard.2010.129643d2010 69: A50Ann Rheum Dis

R Sokolik, B Nowak, M Ponikowska, et al.patients with psoriasis and arthralgiaEarly diagnostic Achilles tendinopathy in

http://ard.bmj.com/content/69/Suppl_2/A50.1.full.htmlUpdated information and services can be found at:

These include:

Referenceshttp://ard.bmj.com/content/69/Suppl_2/A50.1.full.html#ref-list-1

This article cites 3 articles, 1 of which can be accessed free at:

serviceEmail alerting

the box at the top right corner of the online article.Receive free email alerts when new articles cite this article. Sign up in

Notes

http://group.bmj.com/group/rights-licensing/permissionsTo request permissions go to:

http://journals.bmj.com/cgi/reprintformTo order reprints go to:

http://group.bmj.com/subscribe/To subscribe to BMJ go to:

group.bmj.comon September 3, 2013 - Published byard.bmj.comDownloaded from

http://ard.bmj.com/content/69/Suppl_2/A50.1.full.htmlhttp://ard.bmj.com/content/69/Suppl_2/A50.1.full.html#ref-list-1http://ard.bmj.com/content/69/Suppl_2/A50.1.full.html#ref-list-1http://group.bmj.com/group/rights-licensing/permissionshttp://group.bmj.com/group/rights-licensing/permissionshttp://journals.bmj.com/cgi/reprintformhttp://journals.bmj.com/cgi/reprintformhttp://group.bmj.com/subscribe/http://group.bmj.com/http://group.bmj.com/http://group.bmj.com/http://ard.bmj.com/http://ard.bmj.com/http://group.bmj.com/http://ard.bmj.com/http://group.bmj.com/subscribe/http://journals.bmj.com/cgi/reprintformhttp://group.bmj.com/group/rights-licensing/permissionshttp://ard.bmj.com/content/69/Suppl_2/A50.1.full.html#ref-list-1http://ard.bmj.com/content/69/Suppl_2/A50.1.full.html