Entheseal Changes in Response to Age, Body Mass Index, and Physical Activity: An Ultrasound Study in Healthy People

OBJECTIVE: We aimed to investigate the prevalence of ultrasonographic (US) lesions in healthy entheses and contributing factors. METHODS: US scans were performed on 960 entheses of 80 healthy subjects. Factors contributing to entheseal changes were investigated with regression analysis. RESULTS: Thickening (20.4% of the entheses) and enthesophytes (23.1%) were the most common inflammatory and structural damage lesions, respectively. Age (p < 0.001), male sex (p = 0.003), body mass index (BMI; p = 0.001), and high physical activity (p = 0.007) were independent predictors of enthesitis scores on US. CONCLUSION: The effects of age, sex, BMI, and physical activity on the entheses need to be considered when differentiating disease from health.