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Adinolfi A, Iagnocco A, Scirè C, Delle Sedie A, Filippucci E, Sconfienza L, Bertoldi I, Bocci B, Di Sabatino V, Picerno V, Galeazzi M, Frediani B, Filippou G. SAT0312 Ultrasound Reliability in the Diagnosis of Calcium Pyrophosphate Deposition Disease: Agreement Between Observers and Main Causes of Discordance. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Filippou G. SP0123 How to Evaluate CPPD Using Ultrasound. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Adinolfi A, Scirè C, Cimmino M, Delle Sedie A, Filippucci E, Iagnocco A, Sconfienza L, Bertoldi I, Bocci B, Di Sabatino V, Picerno V, Galeazzi M, Frediani B, Filippou G. SAT0315 Calcium Pyrophosphate Dihydrate Deposition Disease: A Proposal of New Ultrasonographic Criteria for CPP Identification in the Joints. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Filippou G, Picerno V, Adinolfi A, Di Sabatino V, Bertoldi I, Galeazzi M, Frediani B. Change perspective to increase diagnostic accuracy of ultrasonography in calcium pyrophosphate dihydrate deposition disease! A new approach: the axial scan of the meniscus. Reumatismo 2015; 66:318-21. [DOI: 10.4081/reumatismo.2014.807] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 02/11/2015] [Indexed: 11/22/2022] Open
Abstract
Ultrasonography (US) is a relevant tool in the study of calcium pyrophosphate dihydrate (CPP) deposition disease. However, differential diagnosis of hyperechoic deposits within the fibrocartilage can be difficult; moreover, US study is limited by the need of an adequate acoustic window. We describe a US scanning technique that offers a new viewpoint in the study of knee meniscal structure: a longitudinal scan performed according to the long axis of meniscus. This technique proves to be particularly useful for the identification of CPP deposition, but could also improve the US diagnostic utility and accuracy in other meniscal pathologies.
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Filippou G, Adinolfi A, Delle Sedie A, Filippucci E, Iagnocco A, Porta F, Sconfienza LM, Tormenta S, Di Sabatino V, Picerno V, Frediani B. Radiologists and rheumatologists on performing and reporting shoulder ultrasound: from disagreement to consensus. Reumatismo 2014; 66:233-9. [PMID: 25376958 DOI: 10.4081/reumatismo.2014.739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 08/16/2014] [Accepted: 08/18/2014] [Indexed: 11/22/2022] Open
Abstract
Shoulder pain is a common condition in the rheumatologist's practice, yet there are no guidelines on how to report shoulder ultrasound (US) examinations. The aim of this study was to compare scanning and reporting techniques performed by radiologists and rheumatologists and identify any discrepancies between the two. The participants in this study were five rheumatologists and two radiologists specialized in musculoskeletal US. The study was divided in 2 phases. In the first phase, each participant performed an US of 3 patients and reported the findings without knowing the patient diagnosis and the findings reported by the other operators. Other three investigators reported the US technique of each operator. Reports and images were subsequently compared to identify any discrepancies and reach consensus on a common approach. In the second phase, a US scan was performed on a fourth patient in a plenary session to assess feasibility and efficacy of the common approach The US scanning technique was similar for all operators. The differences in reporting emerged in the description of the rotator cuff disease. Radiologists provided a detailed description of lesions (measurements along 2 axis and scoring of lesions), whereas rheumatologists described carefully the inflammatory changes. The experts concluded that lesions should be measured along 2 axes and the grade of degeneration and the age of the lesion should be reported. Another difference emerged in the description of the irregularities of the bone surface. The experts concluded that the term erosion should be used only when an inflammatory joint disease is suspected. This study led to the clarification of some inconsistencies in US reporting, and represented an interesting collaborative experience between radiologists and rheumatologists.
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Bertoldi I, Cantarini L, Filippou G, Frediani B. Paget's disease. Reumatismo 2014; 66:171-83. [PMID: 25069498 DOI: 10.4081/reumatismo.2014.789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 07/28/2014] [Indexed: 11/23/2022] Open
Abstract
Paget's disease of bone is the most common metabolic bone disease after osteoporosis and affects 2-4% of adults over 55 years of age. Its etiology is only partly understood and includes both genetic and environmental factors. The disease may be asymptomatic and can be uncovered incidentally on x-ray or in biochemical tests performed for another condition. It can also manifest itself with bone pain, deformity, fracture or other complications. Paget's disease is diagnosed by x-rays and in general has very typical radiological features, but occasionally the clinical picture may be unusual and a differential diagnosis of sclerotic or lytic metastases needs to be considered. Plasma total alkaline phosphatase activity is the most clinically useful indicator of disease activity. It is elevated in most untreated patients, but may be within the normal range in patients with monostotic or limited disease. Bisphosphonate therapy is indicated for patients with symptoms and should also be considered in patients with disease sites that suggest a risk of complications, such as long bones, vertebrae or base of the skull. Orthopedic surgery in Paget's disease patients includes almost exclusively the correction of fractures and arthroplasty.
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Filippou G, Adinolfi A, Carta S, Santoro P, Bertoldi I, Ferrata P, Galeazzi M, Frediani B. SAT0510 Ultrasound versus Synovial Fluid Analysis for the Diagnosis of Calcium Pyrophosphate Dihydrate Deposition Disease: is IT Cppd? Ask Us! Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Picerno V, Filippou G, Bertoldi I, Adinolfi A, Di Sabatino V, Galeazzi M, Frediani B. Prevalence of Baker's cyst in patients with knee pain: an ultrasonographic study. Reumatismo 2014; 65:264-70. [PMID: 24705029 DOI: 10.4081/reumatismo.2013.715] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 02/04/2014] [Accepted: 02/04/2014] [Indexed: 11/23/2022] Open
Abstract
The objectives of this study are to investigate the prevalence of Baker's cyst (BC) in patients with knee pain, and to assess the correlation between BC and severity of osteophytes and joint effusion. A retrospective study was conducted on a group of patients with knee pain referred to our outpatient clinic for ultrasonography of the knee between January 2010 and February 2011. Patients underwent an ultrasonographic exam of the knees to assess the presence of marginal femorotibial osteophytosis, joint effusion and BC. A dichotomous score was assigned to each item (1 present, 0 absent) and severity of US signs of osteoarthritis and joint effusion were also graded semiquantitatively. Collected data were processed using logistic regression analysis to evaluate the correlation between degree of osteophytosis and joint effusion and BC. Patients affected by inflammatory joint conditions or with history of joint surgery or recent trauma were excluded. A total of 399 patients with knee pain were studied (299 women), in the age range 18-89 years (mean 56.2, SD 16.3 years). 293 patients (73.4%) showed sonographic features of osteoarthritis and 251 (62.9%) joint effusion. BC was found in 102 patients (25.8%) together with a positive association with sonographic features of osteoarthritis and joint effusion. Our data show a prevalence of BC of 25.8% in a population of patients with knee pain, and suggest that BC is positively related to osteoarthritis and joint effusion. Ultrasonographic examination of knee is worthwhile in patients with painful osteoarthritis or evidence of effusion.
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Iagnocco A, Porta F, Cuomo G, Delle Sedie A, Filippucci E, Grassi W, Sakellariou G, Epis O, Adinolfi A, Ceccarelli F, De Lucia O, Di Geso L, Di Sabatino V, Gabba A, Gattamelata A, Gutierrez M, Massaro L, Massarotti M, Perricone C, Picerno V, Ravagnani V, Riente L, Scioscia C, Naredo E, Filippou G. The Italian MSUS Study Group recommendations for the format and content of the report and documentation in musculoskeletal ultrasonography in rheumatology. Rheumatology (Oxford) 2013; 53:367-73. [DOI: 10.1093/rheumatology/ket356] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Picerno V, Torzini A, Filippou G, Adinolfi A, Bertoldi I, Sabatino VD, Galeazzi M, Frediani B, Giannini F. 152. The useful of US in diagnosis of carpal tunnel syndrome in diabetics: A proposal for new reference values. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Filippou G, Adinolfi A, Carta S, Lorenzini S, Santoro P, Bertoldi I, Di Sabatino V, Picerno V, Ferrata P, Galeazzi M, Frediani B. FRI0501 Ultrasound versus synovial fluid analysis for the diagnosis of calcium pyrophosphate dihydrate deposition disease: preliminary results. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Filippou G, Di Sabatino V, Adinolfi A, Brizi G, Bertoldi I, Galeazzi M, Frediani B. AB0969 Accuracy of blind intra-articular injections in patients with osteoarthritis of the knee. An ultrasonography controlled study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pierguidi S, Bertoldi I, Adinolfi A, Filippou G, Picerno V, Galeazzi M, Frediani B. AB0535 Effects of tocilizumab on bone density and metabolism in patients with active rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Adinolfi A, Filippou G, Delle Sedie A, Filippucci E, Iagnocco A, Porta F, Sconfienza LM, Tormenta S, Frediani B. FRI0475 Radiologists against rheumatologists on technical aspects of shoulder ultrasound: from the disagreement to final consensus. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Picerno V, Filippou G, Bertoldi I, Topalidis I, Adinolfi A, Galeazzi M, Frediani B. AB1308 Prevalence of baker’s CYST in patients with chronic gonalgia and relationship with major non inflammatory diseases. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Picerno V, Filippou G, Torzini A, Adinolfi A, Di Sabatino V, Bertoldi I, Giannini F, Galeazzi M, Frediani B. SAT0530 The Useful of us in Diagnosis of Carpal Tunnel Syndrome in Diabetics: a Proposal for New Reference Values. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kouloulias V, Asimakopoulos C, Tolia M, Filippou G, Platoni K, Dilvoi M, Beli I, Georgakopoulos J, Patatoukas G, Kelekis N. Sucralfate gel as a radioprotector against radiation induced dermatitis in a hypo-fractionated schedule: a non-randomized study. Hippokratia 2013; 17:126-129. [PMID: 24376316 PMCID: PMC3743615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
External beam radiotherapy with high doses provokes many acute skin reactions, such as erythema and moist desquamation. Many topical preparations are used in radiation oncology departments in the skin care. Sucralfate humid gel, a colloidal physical form of the anti-ulcer drug sucralfate, promotes epithelial regeneration and activates cell proliferation. Based on this knowledge, we performed a non-randomized clinical trial to evaluate the efficacy of topical sucralfate gel in 30 breast cancer patients receiving postoperative accelerated hypofractionated photon beam therapy. The comparison was performed with 30 patients as historical controls. The acute reaction of the skin was significantly lower in the group receiving the sucralfate gel (p<0.05, Mann Whitney test), while 90% of the patients had no evidence of radiation induced skin toxicity. There was no sucralfate gel related toxicity reported by any patient in this study. More patients in a randomized way are needed for more definite results.
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Iagnocco A, Ceccarelli F, Cuomo G, Delle Sedie A, Filippou G, Filippucci E, Grassi W, Porta F, Sakellariou G. Diffusion and applications of musculoskeletal ultrasound in Italian Rheumatology Units. Reumatismo 2013; 65:46-7. [PMID: 23550260 DOI: 10.4081/reumatismo.2013.46] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 12/17/2012] [Accepted: 02/13/2013] [Indexed: 11/23/2022] Open
Abstract
The Musculoskeletal Ultrasound Study Group of the Italian Society of Rheumatology (SIR) was founded during the 68th SIR Congress, on November 2011. The request of activation of this group was based on the increasing interest and the widespread diffusion of ultrasound in the scientific rheumatology community and on the solid experience of some Italian rheumatologists in the field. The aims of the Study Group are to stimulate the applications and use of ultrasound in the clinical practice at the level of the Italian rheumatology units and, in addition, to develop research projects at a national level...
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Filippou G, Frediani B. The diagnosis of calcium pyrophosphate dihydrate crystal deposition disease: the good, the bad and… ultrasonography! Reumatismo 2012; 64:125-7. [DOI: 10.4081/reumatismo.2012.125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 06/27/2012] [Indexed: 11/23/2022] Open
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Filippou G, Frediani B, Gallo A, Menza L, Falsetti P, Baldi F, Galeazzi M, Marcolongo R. The hand: a window to arthritis. Reumatismo 2011. [DOI: 10.4081/reumatismo.2007.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Filippou G, Cantarini L, Bertoldi I, Picerno V, Frediani B, Galeazzi M. Ultrasonography vs. clinical examination in children with suspected arthritis. Does it make sense to use poliarticular ultrasonographic screening? Clin Exp Rheumatol 2011; 29:345-350. [PMID: 21385557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2010] [Accepted: 10/06/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Juvenile idiopathic arthritis (JIA) is a term that encompasses all forms of arthritis that begin before the age of 16 years old, persist for more than 6 weeks and are of unknown cause. The ILAR criteria for JIA classification are based on the number of joints involved. The aim of our study was to compare clinical evaluation and ultrasonography (US) in the assessment of joint synovitis in children with suspected JIA. METHODS We enrolled in our study all children who presented at our outpatient clinic of Paediatric Rheumatology with suspected JIA. All the children underwent a clinical examination for joint swelling (40 joints), a tender joint count (42 joints) and US examination (42 joints) on the same day. They all returned to the clinic after approximately 2 weeks with the results of the tests prescribed at the first visit and a diagnosis was formulated. RESULTS Thirty-one children were enrolled. More synovitis was identified by US than by than clinical examination (42 joints vs. 27). Clinical examination classified as swollen 13 joints that did not result affected at US. Of the 94 painful joints, 24 were affected by synovitis at US. The final diagnoses were: 9 children with JIA (any form), 9 were classified as healthy and 13 with other diseases. One child was reclassified and 2 were diagnosed with JIA thanks to US. CONCLUSIONS US detected more synovitis than clinical examination in children with suspected JIA, therefore, US should be included in the screening procedure of children with suspected JIA.
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Ginanneschi F, Filippou G, Reale F, Scarselli C, Galeazzi M, Rossi A. Ultrasonographic and functional changes of the ulnar nerve at Guyon’s canal after carpal tunnel release. Clin Neurophysiol 2010; 121:208-13. [DOI: 10.1016/j.clinph.2009.09.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Revised: 08/21/2009] [Accepted: 09/02/2009] [Indexed: 11/29/2022]
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Filippou G, Mondelli M, Greco G, Bertoldi I, Frediani B, Galeazzi M, Giannini F. Ulnar neuropathy at the elbow: how frequent is the idiopathic form? An ultrasonographic study in a cohort of patients. Clin Exp Rheumatol 2010; 28:63-67. [PMID: 20346240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Ulnar neuropathy at the elbow (UNE) is the second most frequent focal neuropathy of the arm. The aim of our study was to establish the frequency of anatomical changes of the cubital tunnel capable of causing UNE. METHODS Ninety-one consecutive patients affected by UNE, as established by neurophysiological studies, were enrolled in the study. All patients underwent ultrasonographic examination of the elbow, paying particular attention to the cubital tunnel, which was studied with either static or dynamic scans. RESULT Fifty-four of the 91 patients (59.3%) had at least one anatomical alteration of the cubital tunnel. The changes observed in our patients were: subluxation of the ulnar nerve (18.7%), luxation of the ulnar nerve (9.9%), presence of osteophytes (6.6%), presence of accessory muscle (8.8%), articular ganglion (1.1%), post-traumatic lesions (3.3%), presence of osseous fragment (1.1%). CONCLUSIONS A possible cause of ulnar nerve entrapment at the elbow was found in more than half of the patients. Joint ultrasonography is indispensable for the identification of such alterations as it allows for both static and dynamic evaluation of the ulnar nerve.
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Falsetti P, Frediani B, Acciai C, Baldi F, Filippou G, Marcolongo R. Heel fat pad involvement in rheumatoid arthritis and in spondyloarthropathies: an ultrasonographic study. Scand J Rheumatol 2009; 33:327-31. [PMID: 15513682 DOI: 10.1080/03009740410005395] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Heel fat pad inflammation and degeneration have been frequently proved to cause talalgia. Painful heel fat pad is often confused with plantar fasciitis, and only magnetic resonance imaging (MRI) or ultrasonography (US) can differentiate these conditions. Scanty data are available about heel fat pad involvement in the course of chronic polyarthritis. OBJECTIVE To investigate with US the heel fat pad involvement in patients with rheumatoid arthritis (RA) and spondyloarthropathies (SpA); to describe and compare the clinical and sonographic features of this lesion in the two groups. METHODS The heels of 181 consecutive outpatients with RA and 160 with SpA were studied by US and radiography. A control group of 60 healthy subjects was examined by US. RESULTS Two different patterns of involvement of the heel fat pad were observed. The inflammatory-oedematous pattern was more frequent in patients with RA (6.6%) than in those with SpA (1.8%), and was associated with talalgia--even if it was not associated with plantar fasciitis or enthesophyte (bony spur). The degenerative-atrophic pattern was less frequent (1.1% in RA, 1.9% in SpA), and was associated with plantar fasciitis and subcalcaneal enthesophyte. CONCLUSIONS The inflammatory-oedematous lesion of the heel fat-pad is relatively frequent in RA and causes subcalcaneal pain. Degenerative-atrophic changes of the heel fat pad can be observed in RA and SpA, and seem to be associated with chronic abnormalities of the plantar fascia and of its enthesis.
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Mondelli M, Filippou G. Reply to Granata et al. by Mauro Mondelli and Georgios Filippou. Neurophysiol Clin 2009. [DOI: 10.1016/j.neucli.2009.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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