A relationship between spinal new bone formation in ankylosing spondylitis and the sonographically determined Achilles tendon enthesophytes

Rheumatol Int (2016) 36:397404 DOI 10.1007/s00296-015-3360-8

Rheumatology

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Web End = A relationship between spinal new bone formation in ankylosing spondylitis and the sonographically determined Achilles tendon enthesophytes

Sibel Zehra Aydin1 Meryem Can2 Fatma AlibazOner2 Gokhan Keser3 Esra Kurum4 Vedat Inal3 Veli Yazisiz5 Merih Birlik6 Hakan Emmungil1 Pamir Atagunduz2 Haner Direskeneli2 Dennis McGonagle7 Salih Pay8

Abstract Spinal new bone formation is a major but incompletely understood manifestation of ankylosing spondylitis (AS). We explored the relationship between spinal new bone formation and ultrasound (US)-determined Achilles enthesophytes to test the hypothesis that spinal new bone formation is part of a generalized enthesis bone-forming phenotype. A multicenter, case control study of 225 consecutive AS patients and 95 age/body mass index (BMI) matched healthy controls (HC) was performed. US scans of Achilles tendons and cervical and lumbar spine radiographs were obtained. All images were centrally scored by one investigator for US and one for radiographs, blinded to medical data. The relation between

On behalf of the Turkish Ultrasonography Study Group.

* Sibel Zehra Aydin [email protected]

1 Department of Rheumatology, School of Medicine, Koc University, Guzelbahce sok, No: 20, Nisantasi, 34365 Istanbul, Marmara, Turkey

2 Rheumatology, Marmara University, Istanbul, Marmara, Turkey

3 Internal Medicine-Rheumatology Department Izmir, Ege University Medical School, Izmir, Turkey

4 Statistics, Istanbul Medeniyet University, Istanbul, Marmara, Turkey

5 Department of Internal medicine, Division of Rheumatology, Akdeniz University Hospital, Antalya, Turkey

6 Division of Rheumatology Izmir, Dokuz Eylul University Hospital, Izmir, Turkey

7 Rheumatology LEEDS, Leeds, Yorkshire, UK

8 Division of Rheumatology, Gulhane School of Medicine, Ankara, Turkey

Received: 31 March 2015 / Accepted: 10 September 2015 / Published online: 6 October 2015 Springer-Verlag Berlin Heidelberg 2015

syndesmophytes (by modied Stoke Ankylosing Spondylitis Spine Score (mSASSS) and the number of syndesmophytes) and enthesophytes (with a semi-quantitative scoring of the US ndings) was investigated. AS patients had signicantly higher US enthesophyte scores than HCs (2.1(1.6) vs. 1.6(1.6); p = 0.004). The difference was sig

nicant in males (p = 0.001) but not in females (p = 0.5).

The enthesophyte scores signicantly...