The Association of Achilles Sonoelastography Findings with Disease Activity, Functional Status and Enthesitis Index in Patients with Axial Spondyloarthritis

Abstract

Background Sonoelastography (SE) is a new ultrasound (US)-based technique able to assess tissue elasticity. Using conventional US, it is sometimes difficult or even impossible to distinguish pathologic tissue because it often presents with the same echogenicity as the surrounding healthy tissue. This study aimed to evaluate SE findings in Achilles tendons of patients with axial spondyloarthritis (axSpA) and to assess how these findings are associated with disease-related parameters.

Material and Methods Sixty-four consecutive patients (37 men, 27 women; mean age 39.7 years; range 20–65 years) with axSpA and 30 sex and age-matched healthy controls were enrolled in the study. Disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), whereas functional capacity was evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and the Spondyloarthritis Research Consortium of Canada (SPARCC) enthesitis index were recorded. All participants underwent an SE examination of the Achilles tendon and measurement of the strain index (SI).

Results The mean right and left SI were significantly higher in axSpA patients than in controls (2.96±0.94 vs. 1.90±0.45; p<0.001; 2.95±0.95 vs. 1.92±0.48, p<0.001, respectively). In axSpA patients, both right and left SI were significantly correlated with the BASDAI, BASFI and SPARCC enthesitis indices, but not with ESR or CRP.

Conclusion AxSpA patients had an increased SI compared with healthy subjects and these values were associated with disease activity, functional capacity and the enthesitis index. SE may be a useful tool for the evaluation of Achilles tendons in patients with axSpA.

Zusammenfassung

Hintergrund Die Sonoelastographie (SE) ist ein neuer Ultraschall (US)-basiertes Verfahren zur Beurteilung der Gewebeelastizität. Mit konventionellem US ist es manchmal schwierig oder sogar unmöglich, pathologisches Gewebe zu unterscheiden, da es oft die gleiche Echogenität aufweist wie das umgebende gesunde Gewebe. Das Ziel dieser Studie war es, diese Befunde der Achillessehne bei axialer Spondyloarthritis (ax-SpA) zu bewerten und ihren Zusammenhang mit krankheitsbezogenen Parametern zu beurteilen.

Material und Methoden 64 aufeinanderfolgende Patienten (37 Männer, 27 Frauen; Durchschnittsalter 39,7 Jahre; Bereich 20–65 Jahre) mit ax-SpA und 30 geschlechts- und altersgleichen gesunden Kontrollpersonen wurden in die Studie aufgenommen. Die Krankheitsaktivität wurde unter Verwendung des Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) bewertet, während die funktionelle Kapazität unter Verwendung des Bath Ankylosing Spondylitis Functional Index (BASFI) bewertet wurde. Erythrozytensedimentationsrate (ESR), C-reaktives Protein (CRP), Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis-Index wurden aufgezeichnet. Bei allen Teilnehmern wurde eine SE-Untersuchung der Achillessehne durchgeführt und der Strain index (SI) gemessen.

Ergebnisse Der mittlere rechte und linke SI war bei ax-SpA Patienten signifikant höher als bei den Kontrollen (2,96±0,94 vs 1,90±0,45, P ˂0,001; 2,95±0,95 vs 1,92±0,48, P ˂ 0,001, jeweils). Bei ax-SpA Patienten waren sowohl die rechte als auch die linke SI signifikant mit dem BASDAI, dem BASFI und dem SPARCC-Enthesitis-Index korreliert, nicht aber mit ESR oder CRP.

Schlussfolgerung Ax-SpA-Patienten hatten im Vergleich zu gesunden Probanden einen erhöhten SI und diese Werte waren mit Krankheitsaktivität, funktioneller Kapazität und Enthesitis-Index assoziiert. SE kann ein nützliches Hilfsmittel für die Bewertung der Achillessehne bei ax-SpA sein.

Key words

Achilles tendon - axial spondyloarthritis - sonoelastography - strain index

Schlüsselwörter

Axiale Spondyloarthritis - Achillessehne - Sonoelastographie - Strain index

Publication History

Article published online:
16 March 2022

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