THU0275 The relationship between maastricht ankylosing spondylitis enthesitis score and the spondyloarthritis research consortium of canada enthesitis index in ankylosing spondylitis: friends or enemies?
Authors: W. Hamdi, M. Sellami, H. Riahi, K. Maatallah, D. Kaffel, M. Chelli-Bouaziz, M.F. Ladeb, M.M. Kchir
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The enthesitis screening is critical for the diagnosis and for monitoring the disease activity in axial spondyloarthritis(AS). Several indices have been developed for the clinical evaluation of enthesitis, including the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) in 2003 and the Spondyloarthritis Research Consortium of Canada (SPARCC) in 2008. Each of them has advantages and limitations, but could they be complementary? <h3>Objectives</h3> The objective of our study was to compare the abilities of MASES and SPARCC in detecting enthesitis and to look for possible correlations between these two scores. <h3>Methods</h3> We designed this prospective study in 60 patients meeting modified New York criteria for AS and seen at the rheumatology department. All patients underwent a clinical evaluation, in which scores of MASES (range 0–13) SPARCC (range 0–16) and visual analogue scale (VAS) for entheseal pain were recorded. Ultrasound scans were taken for five entheses sites on both sides in lower limbs (proximal and distal insertions of the patellar tendon, patellar insertion of the quadriceps tendon, and calcaneal insertions of the Achilles tendon and superficial plantar fascia). <h3>Results</h3> Sixty AS patients were enrolled (48 men and 12 women) with a mean age of 36 years<sup><sup>20–74</sup></sup> and mean disease duration of 8.8 years [0.5–25]. Biological inflammation was detected in 51 patients with mean erythrocyte sedimentation rate (ESR) of 33<sup><sup>2–98</sup></sup> and mean C reactive protein of 16.9 mg/L [0–240]. Physical examination found 77/600 painful entheses sites(12.8%), of which quadriceps and calcaneum entheses were the most painful in 16% and 15.8% cases respectively. The mean MASES was 3.4 [0–13] and the mean SPARCC was 2.98 [0–16]. A null MASES and SPARCC scores were recorded in 18 (30%) and 23 (38%) patients respectively. US imaging of the entheses showed peritendinous oedema and bursitis mainly at distal insertions of the patellar tendon in 51% and 55% respectively. Erosions were more likely detected at Achilles tendon site (95.8%). MASES and SPARCC scores were both significantly correlated with VAS for entheseal pain (r=0.52; r=0.46; p&lt;0.0001 respectively), with the BASDAI (r=0.39; r=0.40; p&lt;0.0001 respectively), with BASFI (r=0.45; r=039; p&lt;0.0001), with VAS for global pain (r=0.55; r=0.51; p&lt;0.0001 respectively) and with ESR (r=0.23; p=0.012 for both). The sonographic score for acute enthesitis correlated only with the MASES, however overall sonographic score correlated only with the SPARCC (table 1). The MASES and SPARCC scores were positively correlated (r=0.768; p&lt;0.0001). <h3>Conclusions</h3> Good correlations were found between the 2 enthesitis indices in AS with special sonographic featuresfor each, attesting their complementary relationship. <h3>Disclosure of Interest</h3> None declared