THE FREQUENCY AND ASSOCIATED FACTORS OF CALCANEAL ENTHESITIS IN PATIENTS WITH RHEUMATOID ARTHRITIS

Objective: Chronic synovitis in peripheral joints is the hallmark lesion but enthesal involvement is little known in patients with rheumatoid arthritis (RA). The aim of this study is to draw attention to this issue by defining the frequency, and associated factors of calcaneal enthesitis (CE) in patients with RA. Material and Methods: This single-center study was conducted at our rheumatology outpatient clinic between July 2022 and December 2022. Electronic medical records was reviewed retrospectively. Patients with RA aged ≥18 years were included. Patients having any enthesitis-related non-rheumatic disorders were excluded. Calcaneal enthesitis was defined as the presence of heel pain accompanied by morning stiffness, and radiological evidence of calcaneal enthesitis (as irregular calcaneal spur). Results: We examined totally 616 cases, and 75.8% of them were female. The mean age was 50.5±14.0 years, and the mean disease duration was 7.5±7.3 years. Rheumatoid arthritis-type joint involvement was present in 92.2% (n=568) of study population. Rheumatoid factor (RF) and anti-CCP positivity was 72.6% and 71.8%, respectively. Twenty-seven patients had CE; seven of them had spondyloarthritis (four had psoriasis, two ankylosing spondylitis, one ulcerative colitis). The 3.6% (n=20) of patients had RA-related CE. In univariate analysis, CE+ group had higher age at first symptom for RA (p=0.027), less severe radiographical joint involvement (p=0.016), less RF positivity (p