Heel pain in spondyloarthritis:results of a cross-sectional study of 275 patientsE. Koumakis, L. Gossec,M. Elhai, V. Burki, A. Durnez, I. Fabreguet, M. Meyer,J. Payet, F. Roure, S. Paternotte, M. DougadosParis-Descartes University, Medicine Faculty, APHP, Cochin Hospital, Rheumatology B Department,Paris, France.AbstractObjectivesHeel pain is a common but poorly studied feature of spondyloarthritis (SpA). The aims of this study were to assess the prevalence and clinical features of heel pain in a cohort of patients with SpA.This was a retrolective single centre observational study in 2010. Patients with SpA as defined by Amor’s criteria were recruited. The data collected were: demographic and disease characteristics, history of heel pain, age at first heel pain, localisation, nature and intensity of pain and treatments. The analyses were descriptive.A total of 275 SpA patients (mean age 44.6±13.5 yrs, mean disease duration 16.7±11.8 yrs, 61.5% men) were assessed.A history of heel pain was reported in 130 patients (47.1%), and was the first symptom of SpA in 15.7% of all patients. Heel pain was frequent in both axial (89/201, 44.3%) and peripheral disease (27/56, 48.2%). Distribution was more frequently inferior (88, 69.3%) than posterior (61, 48.0%) (p<0.0001), and frequently bilateral: simultaneously (41.9%) rather than alternatively (29.1%) (p=0.03). Main clinical symptoms were: morning pain on weight bearing (83.6%), but also night pain (34.4%), and/or patient-described swelling (24.2%). Heel pain was frequently recurrent (74.2%), intense (70.3%), source of a limp (71.6%), and often resistant to non-steroidal anti-inflammatory drugs (NSAIDs) (54/108, 50%).Tumour necrosis factor blockers were efficacious on heel pain in 72/94 (76.6%) of cases.This study confirmed heel pain as a frequent symptom in both axial and peripheral SpA. It occurred early in the disease course and it was frequently recurrent and resistant to NSAIDs.spondyloarthritis, heel pain, enthesitis, clinical characteristics, epidemiologyClinical and Experimental Rheumatology 2012; 30 487-491.