The Diagnostic Value Of Peripheral Enthesis Ultrasonic In Spondyloarthritis

Objective: To study the patients with spinal arthritis(SpA)tendon attachment point of occurrence and sonographic findings characteristic,discuss the diagnostic value of ultrasound in the SpA.Methods: Randomly collected outpatient and inpatient SpA patient 80 examples from December 2015 to December 2016 in xinjiang autonomous region people’s hospital gather in the same period in patients with rheumatoid arthritis(RA),50 cases(RA),50 cases of healthy volunteers(HC)as the control group,by two-dimensional color doppler ultrasound in three groups respectively upper 2 tendon attachment point(biceps tendon,supraspinatus tendons)and lower limb five tendon attachment points(quadriceps tendon check point,starting point of patellar tendon,patellar tendon check point,the end of the Achilles tendon and plantar fascia)on ultrasound and ultrasound scores,the relevant data for statistical analysis.Results: 80 patients with SpA,1112 and place attachment point(2 people refused upper body check),abnormal ultrasonic examination found 118,clinical examination found 29 abnormal,there are significant difference between statistical significance(P < 0.01).SpA patients including the AS group of 50 cases,not the AS group 30 cases,12 cases undifferentiated spinal arthritis,psoriatic arthritis,15 cases,reactive arthritis,3 cases),AS of 696,place attachment point ultrasound found 76 exceptions,not the AS group 416 attachment point ultrasound found 42 abnormalities,there was no statistically significant difference between(P > 0.05).SpA group of 1112 patients with 118(10.61%)in the attachment point of abnormal,RA patients 700 attachment point 29(4.1%),abnormal,HC group 700 attachment point 8(1.14%),abnormal,SpA and RA group and HC group differences were statistically significant(P < 0.05);In lower limb attachment point inspection,SpA group slippery bursa phlogistic 46(38.98%),the bone erosion in 31(27.84%),tendon thickening in 16(13.56%),is the most common forms of RA and HC group slippery bursa phlogistic 3 and 2,respectively,bone erosion 1 HC group,both in the control group did not find tendon thickening,SpA and RA group,the HC group differences were statistically significant(P < 0.05);SpA group of patients the Achilles tendon,patellar tendon check point,starting point of the patellar tendon,quadriceps tendon check points,biceps long head tendon abnormality rate respectively(65.25%,15.25,0.85%,65.25%,0.85%);Ultrasonic GUESS BASDAI and back pain VAS scores and patients,morning stiffness time,blood sedimentation,CRP and so on disease activity index(P > 0.05)and no significant correlation;Using Logistic regression analysis was carried out on the various ultrasonic score,results showed that the SpA can be used to predict the diagnosis of the Achilles tendon score and slippery bursa phlogistic score(P < 0.05).Conclusion: ultrasound can detect tendon attachment points abnormity in SpA patients;Especially the Achilles tendon and the patellar tendon check point are most often affected,form with slippery bursa phlogistic,bone erosion,tendon thickening is most common.Achilles tendon score and slippery bursa phlogistic score play an important role in the predictive diagnosis in SpA.