LAUSR

Background Recent studies have developped criteria for US definition of entheseal abnomalities [1] however no actual scores are available to determine the extension and severity of enthesophyte growth in clinical practice. Objectives To evaluate the faseability of two new scores to quantifie enthesophytes occurence and its dimensional changes with time. Methods We have evaluated 816 enthesis two years apart in a consecutive series of 68 IBD patients for the presence and size of enthesopytes. Images were collected at baseline and after 24 months using an Esaote MyLabClass, 18-6 MHz linear multifrequence transducer both in B-mode and PD-mode. The following sites were evaluated bilaterally: lateral epicondyle of the humerus, distal quadricipital insertion at the patella, superior and inferior pole of the patella, Achilles tendon insertion, and plantar aponeurosis insertion. The presence of enthesophyte was scored dichotomously as present (=1) or absent (=0) for each site and summed up to generate the ARE score (ARES). Enthesophytes was also scored semiquantitatively in a 0-3 scale (0 = absent, 1 = minimal, 2 = discrete, 3 = massive) according to Aydin SZ et al. [2] for each site and summed up to generate RES score (RESS). All the stored images were then reviewed and scored by 4 rheumatologists (FM, GC, PM, NG) well trained in US examination of enthesis. ICC inter- and intra-observers was done for each site and for the ARES and RESS. Results ICC was exellent for presence or absence of enthsophytes both intra and inter examinator for all the sites. ICC of the ARE score was excellent (Cronbach alfa = 0.930, 95%CI 0.72-0.98). ICC was excellent also for the semiquantitative RESS at all the examined sites and only moderate at the plantar fascia level (Cronbach alfa = 0.571, 95%CI -0.72-0.89). The total RESS have an exellent ICC (Cronbach alfa = 0.963, 95%CI 0.85-0.99). Conclusion The two scores are easily feasible and have high reliability and and exellent intra- and inter-obeserver reproducibility. References 1. Balint PV, et al. Reliability of a consensus-based ultrasound definition and scoring for enthesitis in spondyloarthritis and psoriatic arthritis: an OMERACT US initiative. Ann Rheum Dis. 2018 Dec;77(12):1730-1735. 2. Aydin SZ, et al. A relationship between spinal new bone formation in ankylosing spondylitis and the sonographically determined Achilles tendon enthesophytes. Rheumatol Int 2016 Mar;36(3):397-404. Disclosure of Interests None declared