Planter Entheseal involvement in Rheumatoid arthritis patients

Introduction: Enthesopathy is one of the impacts of Rheumatoid Arthritis on the musculoskeletal system, this study elucidate the prevalence of planter enthesopathy in patients with Rheumatoid arthritis (RA). Aim of the work: is to determine the prevalence of planter entheseal involvement in rheumatoid arthritis (RA) patients using MSUS and to elucidate its association with disease activity and autoantibodies. Subject and methods: planter entheses were assessed cross-sectionally in 60 RA patients and 60 apparently healthy volunteers, age and sex matched. Clinical and laboratory data were collected to assess disease activity using DAS28 Disease Activity Score, Real-time ultrasonography was performed for detection of planter enthesopathy and abnormalities were quantified using the Madrid Sonography Enthesitis index (MASEI). Results: Clinical enthesitis was found in 58 of 120 examined person, with significant prevalence of planter US enthesopathy in RA patients 30%. Ultrasound (US) examination revealed the presence of one or more abnormalities (entheseal thickening, enthesophytes, erosions,structural abnormalities,PD), with significant association regarding Disease activity score &(Entheseal thickness and PD Signal). But insignificant associations regarding Disease activity score & other US findings. (bone erosion, enthesophyte, structural abnormality).Also insignificant associations between ultrasound findings and autoantibodies(RF ,ACCP). Conclusions: Musculoskeletal ultrasound (MSUS) is an effective technique to perform real time dynamic studies and allows easy comparison with the contralateral side, which can help diagnosis subtle abnormalities. Our work revealed; High prevalence of planter enthesopathy among RA patients, with both Clinical and ultrasonic evidence.