Document Detail


Power Doppler ultrasonography assessment of entheses in spondyloarthropathies: response to therapy of entheseal abnormalities.
MedLine Citation:
PMID:  20810495     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
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.
Authors:
Esperanza Naredo; Enrique Batlle-Gualda; M Luz García-Vivar; Angel M García-Aparicio; Jose Luis Fernández-Sueiro; Manuel Fernández-Prada; Emilio Giner; Manuel Rodriguez-Gomez; Maria Francisca Pina; Julio A Medina-Luezas; Francisco Javier Toyos; Cristina Campos; Ricardo Gutiérrez-Polo; Miguel Angel Ferrer; Olga Martínez; Cesar Díaz-Torne; Teresa Gonzalez; Serafín Campos; Rubén Queiro; Manuel Castaño-Sánchez; Juan José Aznar; Sagrario Bustabad; Manuel Paez-Camino; Roser Tuneu; Teresa Ruiz; Lourdes Mateo; Manuel Pujol; Andrés Ponce; Inmaculada Ros; Angel Gallegos; Juan Moreno; Domingo Gumbau; Manuela Sianes; M Jose Poveda-Elices; Montserrat Romero-Gómez; Enrique Raya;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-01
Journal Detail:
Title:  The Journal of rheumatology     Volume:  37     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  2110-7     Citation Subset:  IM    
Affiliation:
Department of Rheumatology, Hospital Universitario Severo Ochoa, Madrid, Spain. esnaredo@ser.es
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Comment In:
J Rheumatol. 2010 Oct;37(10):1986-8   [PMID:  20889609 ]

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