Tendinous and Ligamentous Derangements in Systemic Lupus Erythematosus

• Published in: Journal of rheumatology Vol. 35; no. 11; pp. 2187 - 2191
• Main Authors: GABRIELA SIERRA-JIMENEZ, ADRIANA SANCHEZ-ORTIZ, FRANCISCO JAVIER ACEVES-AVILA, GUILLERMO HERNANDEZ-RIOS, SERGIO DURÁN-BARRAGÁN, CESAR RAMOS-REMUS
• Format: Journal Article
• Language: English
• Published: Toronto, ON The Journal of Rheumatology 01-11-2008; Journal of Rheumatology Publishing
• Subjects: Adult; Arthritis - diagnostic imaging; Arthritis - epidemiology; Biological and medical sciences; Diseases of the osteoarticular system; Female; Humans; Juxtaarticular diseases. Extraarticular rhumatism; Ligaments - diagnostic imaging; Low Back Pain - diagnostic imaging; Low Back Pain - epidemiology; Lupus Erythematosus, Systemic - diagnostic imaging; Lupus Erythematosus, Systemic - epidemiology; Male; Medical sciences; Middle Aged; Osteitis - diagnostic imaging; Osteitis - epidemiology; Prevalence; Pubic Bone - diagnostic imaging; Radiography; Sacroiliac Joint - diagnostic imaging; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Tendinopathy - diagnostic imaging; Tendinopathy - epidemiology; Tendons - diagnostic imaging; Juxtaarticular disease; Immunopathology; Connective tissue disease; Ligament; Skin disease; Sacro-iliitis; Diseases of the osteoarticular system; Rheumatology; LIGAMENTS SACROILIITIS; Autoimmune disease; Enthesopathy; ENTHESIS; Systemic lupus erythematosus; Systemic disease; TENDONS; Tendon
• ISSN: 0315-162X; 1499-2752
• DOI: 10.3899/jrheum.080255

Objective
We assessed the prevalence of selected clinical and radiological features of tendinous and ligamentous derangements in a consecutive
sample of patients with systemic lupus erythematosus (SLE).
Methods
Consecutive patients with SLE with no comorbidities attending a tertiary care center were prospectively assessed and underwent
plain radiographic evaluation of the pelvis. Radiographs were analyzed by 2 blinded observers; radiographic sacroiliitis was
graded 0 to IV. To better assess sacroiliac (SI) involvement, a computed tomography (CT) scan of the SI joints was performed
in patients with grade III sacroiliitis. Hip joints and pubis were also assessed as described.
Results
Of the 192 included patients, 89% were female, mean age was 36 years, and mean disease duration was 10 years. Inflammatory
low back pain was reported by 10% of patients. Sacroiliitis of any grade was observed in 31 patients (16%), and grade III
(confirmed on CT scan) sacroiliitis was observed in 6% (95% CI 3% to 9%). Osteitis pubis was diagnosed in 6% (95% CI 3% to
10%) and coxofemoral migration in 8% (95% CI 2% to 9%). Jaccoud’s arthropathy was found in 23%. Demographic and clinical variables
were not statistically associated with radiographic sacroiliitis.
Conclusion
Sacroiliitis and other tendinous and ligamentous derangements are not uncommon in patients with SLE. Based on these features
and on previous reports, the term “SLE-related tendinous and ligamentous derangements” may be used to establish a common framework
for further research and reporting.
Key Indexing Terms:
SYSTEMIC LUPUS ERYTHEMATOSUS
TENDONS
LIGAMENTS
SACROILIITIS
ENTHESOPATHY
ENTHESIS