| 1. OBJECIVE Seronegative spondylarthropathies (SpAs) is an interrelated group of multisystem inflammatory disorders which affects the spine, peripheral joints, periarticular structures. Enthesopathy is a characteristic manifestation of SpAs and often neglected by patients with SpAs. There is no effective examinations of enthesopathy. The main aims of this article are to study the sonographic imaging of ligamentuni patella and Achilles tendon in SpA patients, to compare it with healthy volunteers, patients with rheumatoid arthritis (RA) and professional athletes, and to examine the role of sonography (SG) in diagnosis of SpA patients with tendon involvement. 2.METHODS SG was performed using a GE Logiq700 MR Expert Series ultrasound equipment and a 5-10MHz multifrequency linear array transducer. Fifty-eight SpA patients (including thirty ankylosing spondylitis, fifteen spondylarthropathies, five juvenile spondylarthropathies, three psoriatic arthropathy, four reactive arthritis, and one enteropathic arthropathy, forty-four male and fourteen female), fifty-two healthy volunteers (thirty-three male and nineteen female), four RA patients (all female) and twenty professional athletes (nine gymnastics [six male and three female], eleven volleyball players[all female] ) were undergone SO on ligamentum patella and Achilles tendon of both sides. 3.RESULTS 3. 1 Macroscopic Anatomy: After excluding the influence of height and weight, there was no difference in length, width and thickness of ligamentum patella and in width and thickness of Achilles tendon between SpA patients and healthy volunteers.3.2 Gray Scale: The average grey scale of SpA patienis on the insertion ofligameIha patella(93.5t l l .6) and Achilles tendon(82.7i l3.6) to the bone was lowerthan those of the professional athletes(l l8. l t8.2 and l l5.5t7. l respectively), the RApatients (1l0.2t4.0 and l05.5tl4.l respectively) and the healthy volunteers(107.3tl3.5 and 96.3tl0.7 respectively). The average grey sca1e of male SpAspatients was significanly lower than tha of female SpAs patients, than that of maleprofessional athletes and than tha of healthy male voluneers (P< 0.05).3. 3 Echogenicity Characteristics: About 90% of ligameIlta patella and 80% ofAchilles tendons of SpA patients were found abnormalities during SG examination,While the healthy control grouP were ll.5% and l.9% respectively (P< 0.05). Themain abnormalities of sonograPhic imaging of patients with SpA on ligamenta patellaand Achilles tendons were abnormal of the tendon sheath(55.2%) or of contour of theligament(22.4%), abnormalities of the echogenicity inside the ligamentumpatella(5l .7%) and Achilles tendon(25.9%), abnormalities of the bone margin on theinsertion of the ligamentUIn(4l .4%) and of the tendon(50.0%), and so on. There weresignificant difference between the SG abnormalities of patients with SpA and ofhealthy voluneers on the fluid collections within the ligaxnentUrn sheath, the irregularand/or blurred contour of the ligamentUm sheath, the uneven-distIibuted echogenicityinside the ligamentUm, blurred contour of the bone margin of the ligamentUIn patella,and blurred contour of the Achilles tendon, echogenicity abnormalities inside thetendon, abnormalities of the bone margin of on the insertion of Achilles tendon(P<0.05).3. 4 Sensitivity of SG: There were significan correlation between the bonemargin abnormalities, the ligamentUm edema, the blurred colltour of the bone marginon the insertion of ligameAn patella, the inflamed bursa around the end of theligarnentUIn and the enthesopathy manifestation of ligamentUIn patella. There weresignificam correlation betWeen focal hreerechoic pattem inside the tend...
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