ArticleClinical rheumatology2021
Enthesitis may be one of the signs of severe disease in familial Mediterranean fever.
Article in Clinical rheumatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 12 citations in OpenAlex.
- Inflammatory ankle MRI findings in pediatric and young adult patients with familial Mediterranean fever: a comparison with juvenile idiopathic arthritis and chronic nonbacterial osteomyelitis.Skeletal radiology · 2026Article
- Exertional leg pain in pediatric familial mediterranean fever: clinical associations and implications for treatment.European journal of pediatrics · 2026Article
- Familial mediterranean fever in a patient with ankylosing spondylitis: could familial mediterranean fever explain a typical eight-year ankylosing spondylitis?Rheumatology international · 2024Review
- Pivotal role of the synovioentheseal complex in the imaging of arthritis and rheumatic diseasesDiagnostic and interventional radiology (Ankara, Turkey) · 2024Review
- Physical fitness in adolescent patients with familial Mediterranean fever.Rheumatology international · 2024Article
- Importance of hematological markers in familial Mediterranean fever in terms of disease severity and amyloidosis.Rheumatology international · 2023Article
- Apical fibrosis was the most common incidental pulmonary finding in a familial Mediterranean fever cohort.Clinical rheumatology · 2023Article
- Spondyloarthritis in familial Mediterranean fever: a cohort study.Rheumatology international · 2022Article
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Authors and funding
7 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveFamilial Mediterranean fever (FMF) is an auto-inflammatory disease that is also characterized with some of the common musculoskeletal features of spondyloarthritis (SpA). Enthesitis is the hallmark of SpA. Recently, it was postulated that exertional leg pain is a possible sign of lower extremity enthesitis associated with FMF severity. In this study, we have evaluated the association between the enthesitis, enthesitis score and disease severity in FMF patients.
methodsWe enrolled 238 FMF patients that fulfilled the modified Tel-Hashomer criteria. We assessed the presence of enthesitis at the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) defined sites with standard palpation method. Then, FMF patients dichotomised two groups as enthesitis group and controls. Herein, we evaluated the enthesis extensity with MASES. FMF disease severity was determined via the international severity scoring system for FMF (ISSF). Firstly, we have compared demographic properties, disease-related features and ISSF scores of the groups. Then, we have correlated ISSF with MASES in enthesitis group.
resultsWe showed that 54 (22.6%) of 238 patients had enthesitis. The demographic features were similar between the groups. The enthesitis group had higher ISSF scores (p < 0.001); higher frequency of fever (p = 0.004), exertional leg pain (p < 0.001), myalgia (p < 0.001) and arthritis (p = 0.01); and more intense, widespread, frequent and longer attacks compared with controls. Moreover, there was a weak correlation between ISSF and MASES in the patients with enthesitis.
conclusionEnthesitis may be a sign of more severe FMF phenotype and frequently associated with other musculoskeletal manifestations resemble SpA. Key points •More than one-fifth of the patients with FMF would suffer from enthesitis. •The FMF patients with enthesitis had higher ISSF scores; higher frequency of fever, exertional leg pain, myalgia and arthritis; and more intense, widespread, frequent and longer attacks as compared with controls. •Enthesitis may be a sign of more severe FMF phenotype and frequently associated with other SpA-like musculoskeletal feature.
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