Shoulder lesions common feature of ankylosing spondylitis

Shoulder lesions are a common feature of ankylosing spondylitis, a review published in Arthritis & Rheumatism suggests. Lambert et al from the University of Alberta, Canada, undertook a chart review of 400 AS patients. Of these, 100 patients and 285 controls were selected for clinical evaluation. In order to analyse the sensitivity and specificity of shoulder lesions defined by magnetic resonance imaging (MRI), 15 AS patients with a clinically defined shoulder disorder and 91 controls with non-specific shoulder pain were reviewed.Lambert and colleagues report that 3.5% of AS patients complained of shoulder pain, but on clinical evaluation, 24.7% had shoulder involvement. By comparison, the rate of shoulder involvement among controls was 14.2% (pThe MRI finding most specific for AS was intense acromial bone oedema at the deltoid origin, the research team notes. While 41.2% of AS patients with shoulder pain displayed this finding, it was not observed in any of the control subjects.Bone marrow oedema at any entheseal site was noted in significantly more AS shoulders (70.6%) than in control (19.1%) shoulders. In addition Lambert et al comment that erosion of the greater tuberosity with or without adjacent bone oedema had the best combination of sensitivity (58-65%) and specificity (86-92%)."Our results lead us to conclude that in the absence of a significant rotator cuff injury, the presence of entheseal bone marrow oedema (BME) and, in particular, intense entheseal BME or erosive change with adjacent BME strongly suggests the presence of AS," the research team concludes.Reference...