Recherche systématique des enthésopathies au cours des rhumatismes chroniques, résultats et signification pathologique: rapport avec la spondylite érosive et les autres lésions tendineuses ou synoviales

: A routine investigation for rheumatic tendon lesions was conducted in 47 patients with an inflammatory spondylo-arthropathy and in 30 patients with rheumatoid arthritis. The incidence of tendon lesions (calcaneal and extra-calcaneal) differed very significantly (p less than 0.001) between the two groups (58.3% of patients with inflammatory spondylo-arthropathy had at least one tendon lesion, 6.6% of patients with rheumatoid arthritis). These results and data from the literature suggest that rheumatic tendon lesions are a characteristic feature of spondylo-arthropathy in the same way as sacro-iliitis, the absence of subcutaneous nodules, the absence of rheumatoid factor and the high incidence of histocompatibility antigen HLA B27. Together with this diagnostic value, there is also a histopathological value: inflammatory and ossifying tendinitis contrasts with the destructive synovitis of rheumatoid arthritis and can be considered to be a "sign" of inflammatory spondylo-arthropathy. Tendinitis and juxta-articular bone lesions in the limbs, so-called "peripheral" lesions, are similar to the vertebral lesions around the intervertebral disk and the posterior interapophyseal joints found in inflammatory spondylo-arthropathy. These lesions seem to be a common pathological feature, at least in part, with the polyarthropathies of childhood.