Presence of multiple spondyloarthritis (SpA) features is important but not sufficient for a diagnosis of axial spondyloarthritis: data from the SPondyloArthritis Caught Early (SPACE) cohort
| Autor: | M. van Lunteren, Mariagrazia Lorenzin, P. Bakker, Z. Ez-Zaitouni, M. van Oosterhout, D. van der Heijde, Robert Landewé, Inger Jorid Berg, F. A. van Gaalen |
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| Přispěvatelé: | AII - Inflammatory diseases, Clinical Immunology and Rheumatology |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Genetics and Molecular Biology (all) 0301 basic medicine musculoskeletal diseases medicine.medical_specialty Immunology Biochemistry General Biochemistry Genetics and Molecular Biology Young Adult 03 medical and health sciences 0302 clinical medicine Rheumatology Internal medicine Spondyloarthritis medicine Back pain Humans Immunology and Allergy Overdiagnosis Axial spondyloarthritis Spondylarthropathies HLA-B27 Antigen 030203 arthritis & rheumatology Sacroiliac joint business.industry Sacroiliac Joint Baseline data Magnetic Resonance Imaging Low back pain Low Back Pain Outcomes research Algorithms Back Pain Chronic Pain Early Diagnosis Radiography Biochemistry Genetics and Molecular Biology (all) 030104 developmental biology medicine.anatomical_structure Cohort Physical therapy medicine.symptom business |
| Zdroj: | Annals of the rheumatic diseases, 76(6), 1086-1092. BMJ Publishing Group Annals of the Rheumatic Diseases, 76(6), 1086-1092 |
| ISSN: | 0003-4967 1086-1092 |
| Popis: | ObjectivesConcerns have been raised about overdiagnosis of axial spondyloarthritis (axSpA). We investigated whether patients with chronic back pain (CBP) of short duration and multiple SpA features are always diagnosed with axSpA by the rheumatologist, and to what extent fulfilment of the Assessment of SpondyloArthritis International Society (ASAS) axSpA criteria is associated with an axSpA diagnosis.MethodsBaseline data from 500 patients from the SPondyloArthritis Caught Early cohort which includes patients with CBP (≥3 months, ≤2 years, onset ResultsBefore sacroiliac imaging and HLA-B27 testing, 32% of patients had ≤1 SpA feature, 29% had 2 SpA features, 16% had 3 SpA features and 24% had ≥4 SpA features. A diagnosis of axSpA was made in 250 (50%) of the patients: 24% with ≤1 SpA feature, 43% with 2 SpA features, 62% with 3 SpA features and 85% with ≥4 SpA features. Of the 230 patients with a positive ASAS classification 40 (17.4%) did not have a diagnosis of axSpA. HLA-B27 positivity (OR 5.6; 95% CI 3.7 to 8.3) and any (MRI-SI and/or X-SI) positive imaging (OR 34.3; 95% CI 17.3 to 67.7) were strong determinants of an axSpA diagnosis.ConclusionsIn this cohort of patients with CBP, neither the presence of numerous SpA features nor fulfilment of the ASAS classification criteria did automatically lead to a diagnosis axSpA. Positive imaging was considered particularly important in making a diagnosis of axSpA. |
| Databáze: | OpenAIRE |
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