Evaluation of Power Doppler US Technique for the Diagnosis of Spondylarthropathy

Spondylarthritis (SPA) are the second most frequent inflammatory rheumatic disorders and, because it starts early in life and has a chronic progressive course, the impact of this disease on health resources and patient's life quality can be important. Because the characteritic signs of SPA, like radiological evidence of sacro-iliitis, appear late in time, the lag time between the onset first signs of SPA for the patient and the confirmed diagnosis can be very long (up to 8 years). Previous studies proved that patients who are affected by SPA are showing abnormal vascularization of peripheral enthesis more frequently than patients affected by other rheumatic diseases. Ultrasonography in B mode combined with power Doppler (PDUS) is a non invasive and highly sensitive toll which can detect enthesitis and abnormal vsacularization even for the patients who are not showing yet the evidence of SPA's symptomatology. Using PDUS as a early diagnosis tool could lead to the improvement of diagnostic procedures and therapeutic management of SpA and reduce the cost of diagnosis for patient and health insurances.

Inclusion criteria

• patients < 50 years old, consulting for spinal inflammatory symptoms > 3 months duration
• patients consulting for arthritis or tenderness joints > 3 months duration
• patients < 50 years old consulting for enthesitis or dactylitis > 3 months duration
• patients with uveitis and HLA-B27 positivity
• relatives of SpA patients consulting for symptoms suggestive of SpA

Exclusion criteria

• patient with confirmed diagnosis of rheumatic disease (included SpA)
• patient protected by law (patient <18 years old, pregnant woman)
• patient who can't atempt the RMI
• patient who will have difficulties to complete the two years of follow-up