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Goussault C, Albert JD, Coiffier G, Lamer F, Guillin R, Le Goff B, Bouvard B, Dernis E, Ferreyra M, Cormier G, Guggenbuhl P, Perdriger A. Ultrasound characterization of ankle involvement in Löfgren syndrome. Joint Bone Spine 2017; 85:65-69. [PMID: 28343011 DOI: 10.1016/j.jbspin.2017.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Bilateral ankle arthritis is a classic diagnostic criterion for Löfgren syndrome. The objective of this study was to use ultrasonography to characterize the articular and periarticular involvement of the ankles in patients with Löfgren syndrome. METHODS Multicenter descriptive cohort study of patients with Löfgren syndrome who underwent ultrasonography of the ankles. We collected clinical data, imaging study findings, blood test results, and joint fluid properties in patients who underwent joint aspiration. RESULTS Findings from ultrasonography of the ankles in 40 patients were analyzed. The most common B-mode abnormality was subcutaneous edema (26/40), followed by tenosynovitis (22/40), with no differences in frequency across compartments. Joint involvement manifested as synovitis in 7 patients and effusion in 10 patients. Synovitis with increased vascularity by power Doppler was found in 3 patients. No statistically significant associations were found linking synovitis or tenosynovitis to clinical features (age and gender), laboratory tests, or imaging study findings. CONCLUSION Contrary to the classical view, our results indicate that ankle involvement in Löfgren syndrome is more often abarticular than articular. The inclusion of bilateral ankle arthritis among the diagnostic criteria for Löfgren syndrome deserves reappraisal.
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Affiliation(s)
- Claire Goussault
- Service de rhumatologie, CHU de Rennes, hôpital Sud, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France.
| | - Jean-David Albert
- Service de rhumatologie, CHU de Rennes, hôpital Sud, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - Guillaume Coiffier
- Service de rhumatologie, CHU de Rennes, hôpital Sud, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - François Lamer
- Cabinet de rhumatologie, 21, boulevard Franklin-Roosevelt, 35000 Rennes, France
| | - Raphaël Guillin
- Service de radiologie, CHU de Rennes, hôpital Sud, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - Benoit Le Goff
- Service de rhumatologie, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 01, France
| | - Béatrice Bouvard
- Service de rhumatologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Emmanuelle Dernis
- Service de rhumatologie, centre hospitalier du Mans, 194, avenue Rubillard, 72000 Le Mans, France
| | - Marine Ferreyra
- Service de rhumatologie, CH de Vannes, 20, boulevard Général-Maurice-Guillaudot, 56000 Vannes, France
| | - Grégoire Cormier
- Service de rhumatologie, CHD Vendée, boulevard Stéphane-Moreau, 85925 La-Roche-sur-Yon cedex 9, France
| | - Pascal Guggenbuhl
- Service de rhumatologie, CHU de Rennes, hôpital Sud, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - Aleth Perdriger
- Service de rhumatologie, CHU de Rennes, hôpital Sud, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
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