A STUDY OF ENTHESITIS IN SPONDYLOARTHROPATHY IN PATIENTS FROM A TERTIARY CARE SERVICE HOSPITAL

CORRESPONDING AUTHOR:
Dr. Surajit Ghatak,
Professor and HOD,
Department of Anatomy,
All India Institute of Medical Sciences,
Jodhpur.
Email: surajit_ghatak@rediffmail.com

ABSTRACT: INTRODUCTION: The enthesis is defined as the site of insertion of a tendon, ligament, joint capsule, or fascia to bone. A variety of anatomical sites can be symptomatically affected in Spondyloarthropathy. The spectrum of Spondyloarthropathy consists of Primary Ankylosing spondylitis, Reiter's syndrome/ reactive arthritis, Psoriatic arthropathy and arthropathy associated with Inflammatory Bowel Disease. One of the pathologic hallmarks of the disease is entheseal involvement with insertional tendonitis at different locations. AIM: To study the distribution of involved enthesis in patients with spondyloarthropathy. MATERIAL AND METHODS: The study group included 54 patients from diverse age groups and from different geographic areas in India and was carried out in a tertiary care service hospital. All these patients had historical evidence of sacroiliitis in the form of Inflammatory Back Pain and were diagnosed as Spondyloarthropathy according to ESSG criteria. RESULT: The male to female ratio in this study is 8.2:1. The distribution of enthesitis in our study showed a maximum incidence of heel and costosternal joint. The other enthesis involved were greater trochanter, anterior superior iliac spine and ischial tuberosity. MRI was compared against Plain radiography of Sacroiliac joints for detecting sacroiliitis changes. CONCLUSION: The disease expression has been considered different in males and females. The males with Ankylosing spondylitis have more often had radiological spinal changes and hip involvement than their female counterparts. MRI was compared against Plain radiography of Sacroiliac joints for detecting sacroiliitis changes. MRI was found to be better as compared to Plain radiography in detecting early sacroiliitis with a P value <0.05.

KEYWORDS: Enthesitis; Spondyloarthropathy.