Aging and entheses: An ultrasonographic probing of degenerative enthesopathy in a cohort of 147 healthy subjects.

AIM: To investigate the prevalence and features of degenerative enthesopathic changes in a large cohort of healthy individuals by musculoskeletal ultrasound (MSUS) and their relation to age and other demographic features.

METHODS

In this cross-sectional study, 147 healthy subjects (1470 entheses) were examined by MSUS according to the Outcome Measures in Rheumatology guidelines: Achilles tendon, plantar fascia, patellar, and quadriceps insertions of both lower limbs.

RESULTS

The mean age (±SD) of the participants was 43.68 (±14.53) years and 57.1% were female. Enthesopathy has been detected in at least 1 area in 113 subjects (76.87%). Thickening (21.6%) and hypoechogenicity (15.3%) were the most frequent inflammatory findings while enthesophyte (10.13%) was the most prevalent structural one. Age and male gender were significantly correlating with inflammatory (rs  = .341, P = .001/r = .310, P = .001), structural (rs  = .354, P = .001/r = .166, P = .04) and total scores (rs  = .406, P = .001/r = .302, P = .001). More inflammatory changes were noticed in the age group 36-55 years. Body mass index had a positive correlation with inflammatory (rs  = .290, P = .001) and total scores (rs  = 0.298, P = .001) but not with structural lesions (rs  = .154, P = .062).

CONCLUSIONS

Thickening, hypoechogenicity, cortical irregularities, and enthesophytes are frequent degenerative features of enthesopathy. These findings need to be redefined to be more specific for spondyloarthritides. Enthesopathy should be interpreted with caution in the light of the clinical picture, especially in elderly and obese male patients.