{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T10:30:35Z","timestamp":1766572235223,"version":"3.48.0"},"reference-count":21,"publisher":"Termedia Sp. z.o.o.","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reumatologia"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study aimed to evaluate ultrasonographic entheseal abnormalities in patients with radiographic axial spondyloarthritis (r-axSpA) who were in clinical remission for at least 6 months and receiving either nonsteroidal anti-inflammatory drugs (NSAIDs) or biologic agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>Seventy-two r-axSpA patients were included, divided into NSAID users (n = 23) and biologic agent users (n = 49). Demographic and clinical data were recorded. Ultrasound assessment was performed bilaterally at 10 entheseal sites using a\u00a07\u201313 MHz linear probe. Elementary lesions defined by OMERACT \u2013 hypoechogenicity, thickening, power Doppler (PD) signal, calcification, enthesophyte, and bone erosion \u2013 were evaluated and scored on a\u00a0scale of\u00a00\u20133. Inflammation scores included hypoechogenicity, thickening, and PD signal; chronicity scores included bone erosion, enthesophyte, and calcification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A\u00a0total of\u00a0720 entheseal sites were analyzed. The\u00a0quadriceps tendon was the\u00a0most frequently affected site (98.6%), followed by the\u00a0distal patellar tendon (94.4%), Achilles tendon (70.8%), and plantar fascia (70.8%). Hypoechogenicity, thickening, enthesophyte formation, and bone erosion were the\u00a0most common abnormalities, while PD signals and calcifications were rare. Nonsteroidal anti-inflammatory drug users showed significantly higher C-reactive protein (CRP) (0.62 \u00b10.53 vs. 0.41 \u00b10.27 mg\/dl, p = 0.027) and erythrocyte sedimentation rate (ESR) levels (11.91 \u00b17.72 vs. 7.65 \u00b15.66 mm\/h,  p = 0.010) than biologic users, despite similar Axial Spondyloarthritis Disease Acti\u00advity Score with CRP score. Mean inflammation, tissue damage, and total ultrasound (US) enthesitis scores were 4.85 \u00b14.37, 6.44 \u00b14.44, and 11.24 \u00b18.21, respectively, with no significant difference between treatment groups. Seven biologic-treated, overweight, or obese patients had markedly elevated total US scores (30.43 \u00b15.83), suggesting persistent entheseal inflammation and structural damage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ultrasound-based enthesitis scoring may reveal subclinical disease activity in r-axSpA patients in remission, highlighting the\u00a0added value of\u00a0integrating musculoskeletal US into disease monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5114\/reum\/208524","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T10:28:51Z","timestamp":1766572131000},"page":"389-397","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of\u00a0remission in patients with radiographic axial spondyloarthritis using an ultrasonography-based enthesitis score: a\u00a0cross-sectional study"],"prefix":"10.5114","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7889-3051","authenticated-orcid":false,"given":"Emrah","family":"Ko\u00e7","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9028-9930","authenticated-orcid":true,"given":"Burak","family":"Okyar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2745-7700","authenticated-orcid":false,"given":"Sibel","family":"Bak\u0131rc\u0131","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4661-787X","authenticated-orcid":false,"given":"Suade \u00d6zlem","family":"Badak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5713-4120","authenticated-orcid":false,"given":"Ali Nail","family":"Demir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7039-4859","authenticated-orcid":false,"given":"\u0130smail","family":"U\u00e7ar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3778-8351","authenticated-orcid":true,"given":"G\u00f6khan","family":"Sarg\u0131n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5264-3038","authenticated-orcid":false,"given":"Servet","family":"Y\u00fcce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6172-7762","authenticated-orcid":false,"given":"Emine Duygu","family":"Ers\u00f6zl\u00fc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3061","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"ref-1615833","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2014.01.015"},{"key":"ref-1615834","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.108233"},{"key":"ref-1615835","doi-asserted-by":"publisher","DOI":"10.1136\/ard.62.2.127"},{"key":"ref-1615836","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000715"},{"key":"ref-1615837","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2017.188"},{"key":"ref-1615838","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2016.42"},{"key":"ref-1615839","unstructured":"Wakefield RJ, Balint PV, Szkudlarek M, et al. 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