Diagnostic values of history and clinical examination to predict ultrasound signs of chronic and acute enthesitis

CER3338
2008 Vol.26, N°4
PI 0548, PF 0553
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PMID: 18799083 [PubMed]

Abstract

OBJECTIVES:
To examine the diagnostic values of history of chronic enthesitic pain and clinical signs of acutely inflamed entheses to predict ultrasound (US) signs of enthesitis.
METHODS:
Cohort study of 21 consecutive rheumatic out-patients (female/male 18/3) with suspected multiple enthesitis and 12 controls (female/male 10/2). 429 enthesal sites according to the Maastricht Ankylosing Spondylitis Entheses Score (MASES) were evaluated by history, clinical examination, B-mode and power Doppler US. Sensitivity and specificity of history suggesting chronic enthesitic pain and clinical examination suggesting acute enthesitis were calculated using corresponding US findings as reference standard.
RESULTS:
Diagnostic accuracy widely varied between different MASES sites. Sensitivity and specificity of selected MASES points were 66.7 – 86.4 % and 85.0 – 91.7 % for history and 71.4 – 87.0 % and 47.4 – 75.0 % for clinical examination, respectively (p<0.05 for each).
CONCLUSIONS:
At specific enthesal sites, history of chronic enthesitic pain and clinical signs of acute inflammation are sensitive and specific for the diagnosis of chronic and/or acute inflammation.