Enthesitis is regarded as the primary lesion in all spondyloarthritis (SpA) subtypes. The aim of the study is to determine the relationship between disease activity, functionality, quality of life and enthesitis assessment in patients with SpA.

Ninety patients with diagnosis of SpA according to 2009 ASAS criteria were recruited to the study. In the clinical evaluation, BASDAI, ASDAS, BASFI, ASQoL, SF-12 scales were applied. Enthesitis assessments were done clinically by MASES and SPARCC. Bilaterally distal triseps tendon was evaluated clinically. Ultrasonographic enthesis was evaluated by a 10 years-experienced, blinded sonographer according to MASEI.

The mean age was 37.5 and 57 of cases were male. The median scores of BASDAI, ASDAS-CRP, ASDAS-ESR, BASFI, ASQoL, MCS and PCS were 3.9, 3.5, 2.6, 2.5, 7, 44.1 and 41.7, respectively. The median scores of both MASES and SPARCC were 2. The median score of MASEI was 16. Clinical enthesitis scores correlated with disease activity scores, functional status and quality of life measure. No correlation was found between the MASEI and clinical enthesitis score, BASDAI, quality of life measure. There was also correlation between MASEI and ASDAS-CRP, BASFI.

Although clinical enthesitis scores correlated with clinical parameters, but not with biochemical markers and sonographic score. Sonographic score was not correlated with disease activity measure except ASDAS-CRP. The result attributed to clinical scales that were less sensitive. Due to the requirement of scales that depend on more objective methods in evaluation of disease activity, ASDAS-CRP could be preferred compared to other present scales. US confirms its validity and reliability in the assessment of entheseal involvement in patients with SpA. This study proposes also that sonographic detection of enthesopathy should be incorporated into the clinical protocol for evaluating patients with SpA in routine clinical practice.