Can we improve the diagnosis of spondyloarthritis in patients with uncertain diagnosis? The EchoSpA prospective multicenter French cohort

Autor: Dominique Monnet, Sandrine Jousse-Joulin, Sandrine Guis, Bertrand Lecoq, Ariane Leboime, Alain Saraux, Philippe Gaudin, Marie Caroline Guzian, Christian Marcelli, Damien Loeuille, Maria Antonietta D'Agostino, O. Judet, Marie Agnes Timsit, Maxime Breban, Alain Blum, Christophe Chagnaud, Philippe Aegerter, Cécile Hacquard-Bouder, Anne-Christine Rat, Isabelle Chary-Valckenaere, Laurent Grange, Roula Said-Nahal
Přispěvatelé: Service de Rhumatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Ambroise Paré, Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Rhumatologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Rhumatologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Département d'information hospitalière et santé publique, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Ambroise Paré, Clinique de rhumatologie, CHU Grenoble-Hôpital Sud, Imagerie Guilloz [CHRU Nancy] (Service d'imagerie Guilloz), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Nancy, Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Laboratoire Universitaire Santé Environnement Vieillissement, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Physiopathologie, Pharmacologie et Ingénierie articulaires (PPIA), Université Henri Poincaré - Nancy 1 (UHP)-Centre National de la Recherche Scientifique (CNRS), Service de Rhumatologie [CHU Sainte Marguerite], Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Groupe de Recherche et d’Étude du Processus Inflammatoire (TIMC-GREPI), AGeing and IMagery (AGIM), Centre National de la Recherche Scientifique (CNRS)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Joseph Fourier - Grenoble 1 (UJF)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Centre National de la Recherche Scientifique (CNRS)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Joseph Fourier - Grenoble 1 (UJF)-Université Pierre Mendès France - Grenoble 2 (UPMF), Hôpital Ambroise Paré [AP-HP], Département de Radiologie adultes [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Lorraine (UL), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Ambroise Paré [AP-HP], Immunologie et Pathologie (EA 2216), Rhumatologie [Sainte- Marguerite - APHM] ( Hôpitaux Sud), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre Hospitalier Universitaire [Grenoble] (CHU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Ambroise Paré, Immunologie et Pathologie ( EA2216 ), Université de Brest ( UBO ) -IFR148, CHRU Brest - Service de Rhumatologie ( CHU - BREST - Rhumato ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Centre d'Investigation Clinique ( CIC - Brest ), Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Service de rhumatologie, CHU Caen, Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-Hôpital Michallon, Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Ambroise Paré, Imagerie Guilloz [CHRU Nancy] ( Service d'imagerie Guilloz ), Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] ( Pôle S2R )
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Male
Settore MED/16 - REUMATOLOGIA
Dactylitis
Cohort Studies
0302 clinical medicine
Diagnosis
Enthesitis
Prospective Studies
030212 general & internal medicine
10. No inequality
Accuracy
HLA-B27 Antigen
ComputingMilieux_MISCELLANEOUS
Ultrasonography
medicine.diagnostic_test
Doppler
Middle Aged
Magnetic Resonance Imaging
3. Good health
[SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system
Cohort
Female
France
medicine.symptom
Cohort study
Adult
musculoskeletal diseases
medicine.medical_specialty
Adolescent
Physical examination
Sensitivity and Specificity
Young Adult
03 medical and health sciences
Rheumatology
[ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology
Internal medicine
Ultrasound
Spondylarthritis
medicine
Humans
In patient
Sacroiliitis
Aged
030203 arthritis & rheumatology
business.industry
Power Doppler
Ultrasonography
Doppler
Magnetic resonance imaging
Gold standard (test)
medicine.disease
Physical therapy
business
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Follow-Up Studies
Zdroj: Joint Bone Spine
Joint Bone Spine, Elsevier Masson, 2012, epub ahead of print. ⟨10.1016/j.jbspin.2012.02.007⟩
Joint Bone Spine, Elsevier Masson, 2012, 79 (6), epub ahead of print. ⟨10.1016/j.jbspin.2012.02.007⟩
Joint Bone Spine, Elsevier Masson, 2012, 79 (6), pp.586-590. ⟨10.1016/j.jbspin.2012.02.007⟩
Joint Bone Spine, Elsevier Masson, 2012, epub ahead of print. 〈10.1016/j.jbspin.2012.02.007〉
ISSN: 1297-319X
Popis: International audience; Power Doppler ultrasound (PDUS) has proved to be a highly sensitive tool for assessing enthesitis in spondyloarthritis (SpA). In patients with a suspected SpA, diagnosis could be improved by detecting enthesitis with PDUS. OBJECTIVE: To evaluate the performance of PDUS for the diagnosis of SpA alone or combined with other clinical, laboratory and imaging findings in patients consulting for a suspected SpA. METHODS: Prospective, multicenter French cohort study (Boulogne-Billancourt, Brest, Caen, Grenoble, Marseille and Nancy). Outpatients consulting for symptoms suggestive of SpA (inflammatory back pain [IBP], arthritis or inflammatory arthralgia [IA], enthesitis or dactylitis [ED], HLA-B27 positive uveitis [B27+U], familiarity for SpA [Fam]) were recruited and followed up for at least 2years. Sample size was set to 500 patients (for estimated prevalence of SpA of 30±5% after 2years). At baseline, patients were submitted to standardized physical examination, pelvic X-ray, sacroiliac joints magnetic resonance imaging (MRI), HLA-B typing, and other tests judged useful for diagnosis. For each patient, a blinded PDUS examination of 14 enthesitic sites was performed at baseline and at years 1 and 2. Patients were planned to be followed during 5years. The diagnosis of SpA ascertained by an experts' committee, blind to PDUS results, after at least 2years of follow-up, with a revaluation of doubtful patients at 5years will be used as gold standard for evaluating the diagnostic performance of PDUS and the best diagnostic procedure by combining PDUS, clinical symptoms and other tests. RESULTS: Between January 2005 and September 2007, 489 patients were included (96% of the target population). Nineteen patients (0.2%) retired their informed consensus or were lost to follow-up immediately after their inclusion. At baseline, mean age of the 470 remaining patients was 40years, mean duration of symptoms was 6.1years; 42% of them were HLA-B27+ and 63% were female. Primary inclusion criterion was IBP in 53%, IA in 27%, ED in 9%, B27+U in 8% and Fam in 4%. Follow-up is still ongoing. CONCLUSION: We have set up a unique diagnostic cohort which includes the entire spectrum of SpA manifestations. By using PDUS we expected to improve the diagnostic procedure of SpA.
Databáze: OpenAIRE
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