scholarly journals POS0967 DESCRIPTION OF SACROILIAC CT FINDINGS IN PATIENTS WITH ANKYLOSING SPONDYLITIS AGED OVER 50 YEARS: PRELIMINARY RESULTS OF THE CASIAGE STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 748.2-749
Author(s):  
O. Fakih ◽  
M. Chouk ◽  
C. Prati ◽  
D. Wendling ◽  
F. Verhoeven
Keyword(s):  
Ankylosing Spondylitis ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Pelvic Bone ◽  
Factors Associated ◽  
Ct Findings ◽  
Total Score Range ◽  
Computed Tomography Scanning ◽  
Duration Of Disease ◽  
Si Joint

Background:Diagnosis of axial spondyloarthritis (SpA) is nowadays commonly made with the help of pelvic radiography or MRI. However, there is an important inter-observer variability for radiographs, and MRI is subject to possible false positives, and is not the best modality for studying structural lesions. Conversely, pelvic CT has an excellent specificity and appears to be more effective than radiography for the diagnosis of SpA [1]. However, CT findings in patients over 50 years of age have not been studied.Objectives:To describe sacroiliac (SI) joint CT characteristics in patients with ankylosing spondylitis (AS), aged 50 years or older.Methods:An observational, cross sectional study was performed using medical records from Besançon University Hospital’s rheumatology department, which were screened to identify patients with AS. A search was then carried out for patients over 50 years old in the hospital’s imaging archiving system to identify those who had benefited from a CT which included the SI joints in their entirety. Non-inclusion criteria were the existence of pelvic bone lesions and a history of pelvic radiotherapy. For each patient, CT was interpreted using a score previously used by Diekhoff et al. [2], dividing each SI joint into 12 regions, for each of which joint space narrowing (JSN), erosions, and sclerosis are assessed. For this study, we also observed the existence of intra-articular gas and diffuse idiopathic skeletal hyperostosis (DISH) lesions for each region. Quantitative variables are expressed as mean ± standard deviation, qualitative variables as numbers and percentages. Wilcoxon rank-sum test was used to determine factors associated with a higher CT score.Results:A total of 66 patients were included. Mean (SD) age was 65.10 ± 10.59 with a mean (SD) duration of disease of 22.87 ± 14.95 years. 60.29% were male, and 87.04 % were HLA-B27 positive. 40.30% had a bamboo spine. CT findings are described in Table 1. The vast majority of patients have a positive JSN score but significant erosions are found in only a minority of cases. This is partly explained by the fact that 55.9% of the patients had at least one complete bilateral ankylosis (and therefore no erosions) on one of the three slices studied. Bilateral anklylosis was associated with a longer duration of disease (p<0.001) and presence of bamboo spine (p<0.001). Also noteworthy is the low proportion of DISH compared to the general population in this age group, which is 15-25%.Factors associated with a higher total CT score were male sex (p=0.017), longer duration of disease (p<0.001), tobacco use (p=0.033), presence of bamboo spine (p=0.004), absence of DISH (p=0.045) and absence of intra-articular gas (p<0.001). The distribution of lesions appeared to be homogenous over all 24 regions studied (Figure 1).Conclusion:CT findings in AS patients over 50 years of age are mostly represented by changes in joint space, with bilateral ankylosis present in half of the patients. AS appears to be a protective factor for DISH.References:[1]Devauchelle-Pensec V, D’Agostino MA, Marion J, et al. Computed tomography scanning facilitates the diagnosis of sacroiliitis in patients with suspected spondylarthritis: Results of a prospective multicenter French cohort study. Arthritis Rheum 2012;64:1412–9. doi:10.1002/art.33466[2]Diekhoff T, Hermann K-GA, Greese J, et al. Comparison of MRI with radiography for detecting structural lesions of the sacroiliac joint using CT as standard of reference: results from the SIMACT study. Ann Rheum Dis 2017;76:1502–8. doi:10.1136/annrheumdis-2016-210640Table 1.Sacro-iliac CT findings using a score modified from Diekhoff et al.Mean total score (range 0-108)70.36±38.90Presence of joint space narrowing58 (85.29 %)Presence of erosion20 (29.41 %)Presence of sclerosis15 (22.06 %)Presence of Intra-articular gas22 (32.35 %)Presence of DISH3 (4.41 %)Figure 1.Mean scores per region in the anterior, central and posterior SI slices (JSN: joint space narrowing (0-4), Ero: erosions (0-3), Scl: sclerosis (0-2)).Disclosure of Interests:None declared.

Construct Validity of Radiographs of the Feet to Assess Joint Damage in Patients with Gout

2016 ◽  
Vol 44 (1) ◽  
pp. 91-94 ◽  
Author(s):  
Bart Spaetgens ◽  
Caroline van Durme ◽  
Casper Webers ◽  
An Tran-Duy ◽  
Thea Schoonbrood ◽  
...  
Keyword(s):  
Construct Validity ◽  
Joint Space Narrowing ◽  
Disease Duration ◽  
Negative Binomial ◽  
Joint Damage ◽  
Joint Space ◽  
Factors Associated ◽  
Erosion Score ◽  
Method Factors ◽  
Linear Regressions

Objective.To investigate construct validity of radiographic damage of the feet in gout.Methods.Radiographs of the feet were scored using the Sharp/van der Heijde method. Factors associated with damage were investigated by a negative binomial model, and contribution of damage to health by linear regressions.Results.Age, disease duration, serum uric acid, and tophi were associated with being erosive and erosion score. Tophi were associated with joint space narrowing. Erosions were associated (β 0.47, 95% CI 0.09–0.84) with physical function, but damage was not associated with overall physical health.Conclusion.Our results support construct validity for radiographs of the feet when assessing joint damage in gout.

scholarly journals AB0727 WORK OUTCOMES AND ASSOCIATED FACTORS IN ANKYLOSING SPONDYLITIS PATIENTS IN CHINA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1658.1-1658
Author(s):  
L. Tu ◽  
Y. Xie ◽  
Q. Lv ◽  
M. Yang ◽  
Z. Liao ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ankylosing Spondylitis ◽  
Disease Duration ◽  
Productivity Loss ◽  
Work Productivity ◽  
Work Outcomes ◽  
Activity Impairment ◽  
Factors Associated ◽  
The Impact

Background:Poorer work productivity due to pain and functional impairment is commonly seen in ankylosing spondylitis (AS) patients, which may contribute to huge social economic burden. However, data about work outcomes and associated factors in Chinese AS patients were barely reported.Objectives:To assess work outcomes and identify factors associated with poor work productivity in patients with AS in China.Methods:A cross-sectional study was conducted in China. Adult patients (aged ≥ 18 years) fulfilled the 1984 New York modified criteria of AS were enrolled from rheumatology center from Jan 2017 to Aug 2017. All participants completed questionnaires about socio-demographic characteristics, disease characteristics, quality of life and the Work productivity and activity impairment questionnaire in AS (WPAI:SpA) to accesses the impact of chronic health conditions on job performance and productivity. Factors associated with work outcomes were evaluated.Results:A total of 91 patients with AS were included: 87.8% males, 78.02% employed, mean age and disease duration of 30 and 10 years respectively. The mean (SD) activity impairment of all patients was 48.57% (22.02%). For patients with employed work, mean (SD) absenteeism, presenteeism and work productivity loss were 10.22% (19.44%), 43.86% (22.48%) and 47.92% (25.81%) respectively. In multivariable analysis, activity impairment was associated with Bath Ankylosing Spondylitis Functional Index (BASFI) (P<0.01) and Ankylosing Spondylitis Quality of Life (ASQoL) (P<0.01). Absenteeism was associated with disease duration (P=0.03). Presenteeism was associated with disease duration (P=0.04), BASFI (P<0.01) and ASQoL (P<0.01). Work productivity loss was associated with BASFI (P<0.01) and ASQoL (P<0.01).Conclusion:Longer disease duration, reduced physical function and poorer quality of life are associated with reduced work productivity in Chinese AS patients.References:[1]Boonen A, van der Heijde D, Landewe R, Spoorenberg A, Schouten H, Rutten-van Molken M, et al. Work status and productivity costs due to ankylosing spondylitis: comparison of three European countries. Annals of the rheumatic diseases. 2002;61(5):429-37.[2]Martindale J, Shukla R, Goodacre J. The impact of ankylosing spondylitis/axial spondyloarthritis on work productivity. Best Pract Res Clin Rheumatol. 2015;29(3):512-23.[3]Castillo-Ortiz JD, Ramiro S, Landewe R, van der Heijde D, Dougados M, van den Bosch F, et al. Work Outcome in Patients With Ankylosing Spondylitis: Results From a 12-Year Followup of an International Study. Arthritis Care Res (Hoboken). 2016;68(4):544-52.[4]Sag S, Nas K, Sag MS, Tekeoglu I, Kamanli A. Relationship of work disability between the disease activity, depression and quality of life in patients with ankylosing spondylitis. J Back Musculoskelet Rehabil. 2018;31(3):499-505.[5]Goh Y, Kwan YH, Leung YY, Fong W, Cheung PP. A cross-sectional study on factors associated with poor work outcomes in patients with axial spondyloarthritis in Singapore. Int J Rheum Dis. 2019;22(11):2001-8.Disclosure of Interests:None declared

scholarly journals AB1112 THE DIAGNOSTIC OF THE OSTEOARTHRITIS OF THE HANDS BY CONVENTIONAL RADIOGRAPHY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1845.2-1846
Author(s):  
D. Kudinsky ◽  
L. Alekseeva ◽  
A. Smirnov ◽  
A. Volkov ◽  
O. Alekseeva ◽  
...  
Keyword(s):  
Disease Duration ◽  
Conventional Radiography ◽  
Joint Space ◽  
Diagnostic Methods ◽  
Stage Ii ◽  
L System ◽  
Informed Consent Form ◽  
Independent Form ◽  
Duration Of Disease ◽  
Radiological Changes

Background:The most severe phenotype of osteoarthritis (OA) is currently considered to be an inflammatory or erosive phenotype (EOA). There is currently no reliable x-ray picture of this disease in the literature, and the question of whether it is an independent form of OA, a natural more pronounced stage of progression, or a separate nosology is debated in the literature.Objectives:To identify the localization, frequency, and severity of pain and radiological symptoms in patients with EOA and non-erosive (NOA) disease in the interphalangeal (DIP and PIP) and metacarpal (MCP) joints of the hands.Methods:64 women with diagnosis of OA of the hand (HOA) joints according to the ACR criteria were included into study after signing the informed consent form. Mean age was 65.28 ± 6.82 years (48-77), mean BMI 27,7 ± 4,4 kg/m2, mean disease duration 12 ± 8,1 years. Individual patient’s medical record included relevant anthropometric data, records from case history and clinical examination, AUSCAN scores, patient’s articular status. Instrumental diagnostic methods included plain radiography of the hand joints in an anterior-posterior projection. The images were described in accordance with the Kellgren&Lawrence (K&L) system.When evaluating radiographs of 64 patients with HOA, the most common was stage II (49%) according to K&L, and the most common symptoms in distal (DIP), proximal (PIP) interphalangeal and MCP were joint space narrowing (JSN) (100%, 100%, and 95%, respectively) and osteophytes (OP) (88%, 70%, and 45%, respectively). Subchondral osteosclerosis (SO) (5%), erosions (8%), and subluxations (3%) in MCP, as well as subluxation in PIP (6%) were less common. Statistica 10.0 was used for statistical analysis.23 patients had EOA, 37 had NOA. Depending on the presence of erosions in interphalangeal joints patients were divided into 2 groups comparable in terms of age, age of OA onset and duration of disease (the average age of patients with EOA interphalangeal joints was 68 + 6.15 years, and mean disease duration 18,34 + 7.11 years; in the group without erosive changes in the average age amounted to 65,13±5.43 years, mean disease duration of 16.56±8.4 years).Results:EOA DIP and PIP was detected in 15 (23%) with radiological changes corresponding to stages III-IV of HOA and in 8 people (12%) with stage II on the K&L scale. Patients with stage I according to standard radiography had no erosive process.In DMFs OP (100% and 78%, OR=1.28, 95%, CI [1.08-1.5], p=0.02), SO (74% and 11%, OR=6.8, 95%, CI [2.6-17.8], p<0,0001), subchondral cysts (SC) (61% and 24%, OR=2.5, 95%, CI [1.3-4.82], p=0.005) and subluxations (43% and 14%, OR=3.2, 95%, CI [1.3-8.23], p=0.01) were significantly more often found in patients with EOA. In PIPs SO (43% AND 5%, OR=8.04, 95%, CI [1.93-33.5], p=0.0005), SC (52% and 27%, OR=1.93, 95%, CI [0.1-3.73], p=0.045) and subluxations (17% and 0%, p=0.01) were significantly more frequently detected in patients with EOA compared to the non-erosive group. According to the results of the AUSCAN questionnaire, a significantly greater severity of pain was found in patients with EOA (65%) in comparison with the non-erosive (30%) form of HOA (OR=2.19, 95%, CI [1.23-3.9], p=0.008).Conclusion:DIPs is most often affected in OA of interphalangeal joints, less often PIPs, the most common symptoms are JSN and OP. At EOA in addition to more frequent detection OP, cysts, SO, subluxations in DIPs, SO, cysts and subluxations in PIPs, there is also significantly more pronounced pain according to AUSCAN data, it can be concluded that EOA is more severe in comparison with the non-erosive form of HOA.Disclosure of Interests:Danil Kudinsky: None declared, Ludmila Alekseeva Grant/research support from: Bayer, Alexander Smirnov: None declared, Alexander Volkov: None declared, Olga Alekseeva: None declared, Elena Taskina: None declared, Anastasiia Sukhinina: None declared

Film-Screen Vs. Digital Radiography in Rheumatoid Arthritis of the Hand

1994 ◽  
Vol 35 (4) ◽  
pp. 311-318 ◽  
Author(s):  
Á. Jónsson ◽  
A. Borg ◽  
P. Hannesson ◽  
K. Herrlin ◽  
K. Jonsson ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Soft Tissue ◽  
Digital Radiography ◽  
Joint Space Narrowing ◽  
Digital Images ◽  
Roc Curves ◽  
Joint Space ◽  
Hard Copy ◽  
Significant Difference ◽  
Soft Tissue Swelling

In a prospective investigation the diagnostic accuracy of film-screen and digital radiography in rheumatoid arthritis of hands was compared. Seventy hands of 36 patients with established rheumatoid arthritis were included in the study. Each of 11 joints in every hand was evaluated regarding the following radiologic parameters: soft tissue swelling, joint space narrowing, erosions and periarticular osteopenia. The digital images were obtained with storage phosphor image plates and evaluated in 2 forms; as digital hard-copy on film and on a monitor of an interactive workstation. The digital images had a resolution of either 3.33 or 5.0 lp/mm. ROC curves were constructed and comparing the area under the curves no significant difference was found between the 3 different imaging forms in either resolution group for soft tissue swelling, joint space narrowing and erosions. The film-screen image evaluation of periarticular osteopenia was significantly better than the digital hard-copy one in the 3.33 lp/mm resolution group, but no significant difference was found in the 5.0 lp/mm group. These results support the view that currently available digital systems are capable of adequate diagnostic performance.

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