Can power Doppler ultrasound of the entheses help in classifying recent axial spondyloarthritis? Data from the DESIR cohort
| Autor: | Philippe Le Corvoisier, Salah Ferkal, Damien Loeuille, Maxime Dougados, Severine Thibault, Pascal Claudepierre, Maria Antonietta D'Agostino, Jean Pierre Daures, Cécile Poulain, Alain Rahmouni |
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| Přispěvatelé: | Service de Rhumatologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Settore MED/16 - REUMATOLOGIA Spondyloarthropathy Immunology 03 medical and health sciences 0302 clinical medicine Rheumatology ankylosing spondylitis medicine Immunology and Allergy 030212 general & internal medicine Axial spondyloarthritis Spondylarthropathies ComputingMilieux_MISCELLANEOUS 030203 arthritis & rheumatology Ankylosing spondylitis business.industry enthesitis Desir cohort Enthesitis ultrasonography spondyloarthritis Enthesis medicine.disease 3. Good health tendinitis Cohort Radiology medicine.symptom business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| Zdroj: | RMD Open : Rheumatic & Musculoskeletal Diseases RMD Open : Rheumatic & Musculoskeletal Diseases, EULAR ; BMJ, 2018, 4 (2), pp.e000686. ⟨10.1136/rmdopen-2018-000686⟩ RMD Open |
| ISSN: | 2056-5933 |
| Popis: | Early diagnosis of axial spondyloarthritis (axSpA) remains a challenge due to the lack of specificity of clinical symptoms and variable prevalence of axial imaging findings permitting a definite diagnosis. Power Doppler ultrasonography (PDUS) of the entheses has demonstrated to be a potential useful tool for the classification and diagnostic management of early SpA independently of the phenotype.Objectives To assess the classification value (sensitivity and specificity) of PDUS-defined enthesitis for identifying patients fulfilling Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axSpA (ASAS+) in patients with recent inflammatory back pain (IBP) (the DESIR (DEvenir des Spondylarthropathies Indifférenciées Récentes) cohort).Methods Baseline PDUS was performed at eight entheseal sites, and PDUS enthesitis was defined by the presence of vascularisation at entheseal insertion.Results 402 patients from the DESIR cohort underwent a PDUS evaluation. PDUS enthesitis was detected in 58 (14.4%) patients of whom 40 (14.2%) belonged to the ASAS+ patients and 18 (17%) to the ASAS- patients. The sensitivity of PDUS enthesitis was 13.9% and the specificity was 83.5%, with a positive predictive value of 69% and 26.8% of negative predictive value for meeting ASAS criteria for axSpA. Of the 18 ASAS- patients with positive PDUS, 59% fulfilled Amor’s criteria, 88% European Spondyloarthropathy Study Group criteria and 59% both.ConclusionsIn a cohort of patients with recent IBP, the prevalence of PDUS enthesitis was low (14.4%); however, its specificity for classifying patients as axSpA according to ASAS criteria was high (83.5%). PDUS enthesitis might be of additional value for classifying as patients with axSpA IBP who do not fulfil ASAS criteria. |
| Databáze: | OpenAIRE |
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