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Revista Paraguaya de Reumatología

versão On-line ISSN 2413-4341


OJEDA, Aldo et al. Ultrasonographic evaluation of enthesis involvement in patients with spondyloarthritis. Rev. parag. reumatol. [online]. 2020, vol.6, n.2, pp.70-78. ISSN 2413-4341.


The enthesis is the target organ of inflammation in spondyloarthritis (SpA), being key in its physiopathology. Ultrasound is becoming the preferable technique to de- tect enthesitis. This study was done to describe the ultrasonographic characteristics of enthesis involvement in patients with spondyloarthritis

Materials and methods:

We evaluated 20 patients with diagnosis of SpA who presented to Hospital de Clinicas. We investigated clinical and demographic variables and later perfor- med ultrasound evaluation of 12 enthesis areas, calculating the GUESS (Glasgow Enthesitis Scoring System) and MASEI (Madrid Sonographic Enthesitis Index) scores with susequent correlation between ultrasonographic and clinical variables.


The BASDAI, ASDAS and BASFI scores were 4.05, 2.35, and 3.56 respectively. Out of the 240 evaluated enthesis, 35 (14.5%) had pain during clinical evaluation.

Thickening of the tendon or ligament was found in 42.5% of all enthesis, 24.1% showed calcification, 10.8% showed erosions, and PD signal was seen in 1.25%.

The average GUESS score was 8.45 and the average MASEI score was 15.2. No relation between sonographic scores and BASDAI, ASDAS or BASFI scores were found.

There was no significant difference between GUESS and MASEI scores with different types of SpA, age, disease duration or type of treatment. Male gender and axial involvement was associated with higher GUESS and MASEI scores.


We found poor correlation between the presence of enthesitis symptoms and the ultrasonographic findings. The MASEI and GUESS scores did not correlate with disease activity scores. The values of MASEI and GUESS scores were related to male gender and predominantly axial involment in patients with SpA. There was very low acute inflammatory findings with Power Doppler signal detection.

Palavras-chave : ultrasound; spondyloarthritis.

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