Association between osteophytes at the enthesis of the Achilles tendon or plantar fascia and tendon thickening on ultrasound imaging

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  • NISHINO Seigo
    Department of Clinical Laboratory, Japanese Red Cross Society Yamaguchi Hospital
  • MATSUDA Yuko
    Department of Clinical Laboratory, Japanese Red Cross Society Yamaguchi Hospital
  • KAWASHIMA Asako
    Department of Clinical Laboratory, Japanese Red Cross Society Yamaguchi Hospital
  • YOSHIMOTO Tomoko
    Department of Clinical Laboratory, Japanese Red Cross Society Yamaguchi Hospital
  • SAITO Hiroshi
    Department of Clinical Laboratory, Japanese Red Cross Society Yamaguchi Hospital
  • KAMO Kenta
    Department of Orthopedics Surgery, Japanese Red Cross Society Yamaguchi Hospital

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Other Title
  • アキレス腱付着部と足底腱膜付着部の骨棘と超音波画像における腱肥厚との関連

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Purpose: Achilles tendonitis and plantar fasciitis are features of spondyloarthritis (SpA) that are used to evaluate the activity of SpA. There were few reports about the association between osteophytes at the entheses and the thickness of entheseal insertions. We aimed to clarify the association between osteophytes at the enthesis of calcaneus and the thickness of Achilles and plantar entheseal insertions. Subjects and Methods: We screened for SpA in 165 patients between June 2014 and November 2015. We excluded the patients who were diagnosed with SpA, rheumatoid arthritis, and other collagen diseases, and who had heel pain. Ninety-one feet were included. We evaluated osteophytes at the enthesis of calcaneus (lateral image) and the thickness of Achilles and plantar entheseal insertions by ultrasound examination. Results and Discussion: In the case of Achilles entheseal insertions, the thickness of positive osteophytes at the enthesis was thicker than that of non-osteophytes at the enthesis (4.45±0.78 and 3.96±0.65, p⟨0.01). In the case of plantar entheseal insertions, there was no association between the thickness and osteophytes at the enthesis (2.85±0.48 and 2.77±0.64, p=0.52). Osteophytes at the enthesis of the Achilles tendon develop within the insertions, but osteophytes at the enthesis of the plantar fascia do not develop within the plantar fascia. This difference may reflect the mechanism of the osteophyte during enthesis formation. Conclusion: Osteophytes at the enthesis may cause thicker Achilles entheseal insertions. Therefore, we should carefully interpret the thickness of calcaneus insertions in cases with an osteophyte at the enthesis.

Journal

  • Choonpa Igaku

    Choonpa Igaku 43 (5), 663-668, 2016

    The Japan Society of Ultrasonics in Medicine

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