Prevalence of Inflammatory Back Pain and Axial Spondyloarthritis Among University Employees in Izmir, Turkey

2015 ◽  
Vol 42 (9) ◽  
pp. 1647-1651 ◽  
Author(s):  
Fatos Onen ◽  
Dilek Solmaz ◽  
Pinar Cetin ◽  
Ismail Sari ◽  
Ali Balci ◽  
...  
Keyword(s):  
Back Pain ◽  
Axial Spondyloarthritis ◽  
Age At Onset ◽  
Turkish Population ◽  
The United States ◽  
Classification Criteria ◽  
Inflammatory Back Pain ◽  
Face To Face ◽  
Asas Criteria ◽  
Asas Classification Criteria

Objective.To estimate the prevalence of inflammatory back pain (IBP) and axial spondyloarthritis (axSpA) using the Assessment of SpondyloArthritis International Society (ASAS) classification criteria among employees in a university.Methods.In the first stage of the study, a face-to-face interview was done using a standard questionnaire to investigate IBP in 381 subjects randomly selected from 2894 employees at Dokuz Eylul University in Izmir, Turkey. In the second stage, subjects with back pain for ≥ 3 months and age at onset < 45 years were evaluated for axSpA using the ASAS criteria. Both the European Spondyloarthropathy Study Group (ESSG) criteria and Amor criteria were used for the classification of the whole group of spondyloarthritis (SpA).Results.There were 131 male and 250 female subjects (mean age: 38.0 yrs). Twenty-five subjects (6.6%) were classified as having IBP according to the ASAS criteria. The prevalence of IBP according to the Berlin and Calin criteria was 7.1% and 21.5%, respectively. The prevalence of axSpA was estimated at 1.3% according to the ASAS classification criteria (0.5% for radiographic axSpA and 0.8% for nonradiographic axSpA). A total of 7 patients (1.8%) fulfilled both the Amor and ESSG criteria for the whole group of SpA.Conclusion.This is the first prevalence study of IBP and axSpA using ASAS classification criteria in the Turkish population. The prevalence estimates of IBP and axSpA reported here are within the upper range of other studies in European countries and the United States.

scholarly journals SAT0380 ENHANCING RHEUMATOLOGY REFERRALS AMONG INFLAMMATORY BOWEL DISEASE PATIENTS WITH SUSPECTED AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1138.2-1138
Author(s):  
C. S. E. Lim ◽  
M. Tremelling ◽  
L. Hamilton ◽  
A. Macgregor ◽  
K. Gaffney
Keyword(s):  
Back Pain ◽  
Musculoskeletal Pain ◽  
Chronic Back Pain ◽  
Axial Spondyloarthritis ◽  
Inflammatory Back Pain ◽  
Aminosalicylic Acid ◽  
Research Support ◽  
Clinical Probability ◽  
Asas Criteria ◽  
History Of

Background:Axial spondyloarthritis (axSpA) is associated with inflammatory bowel disease (IBD). In IBD patients, the clinical probability of axSpA increases in those with chronic back pain (CBP) whose symptoms started before the age of forty-five years old. In practice, this should trigger a rheumatology review especially if accompanied by other symptoms suspicious of inflammatory disease. However, in any health system, the goal of identifying all possible cases need to be balanced with the practical realisation of the finite resources available.Objectives:The study aimed to define the clinical characteristics of a subgroup of IBD patients who are routinely managed in secondary care who have an increased clinical probability for axSpA. Identification of these characteristics may help improve the quality and specificity of referrals to Rheumatology from Gastroenterology clinics.Methods:An analytical cross-sectional study was undertaken. Consecutive IBD patients attending routine Gastroenterology clinics were sent a modified validated back pain questionnaire. The questionnaire included the presence or absence of a previous diagnosis of axSpA; components of validated inflammatory back pain criteria; diagrams to indicate the location of back pain and other musculoskeletal pain; personal and family history of known axSpA manifestations; and details of their IBD course, activity and treatment.IBD patients, with back pain duration > 3 months with onset before 45 years were considered to have a medium diagnostic probability (MDP) for axSpA. MDP-positive IBD patients were compared with MDP-negative IBD patients and logistic regression was used to model the association with clinical features.Results:Four hundred and seventy consecutive IBD patients (mean age 54 years; 46% male) were surveyed. Two hundred and nine patients (59%) replied, of whom 191 patients (69%) consented to participate. One hundred and seventy-three (91%) of those who consented had a valid completed questionnaire and were included for data analysis. Of these, 74% had Ulcerative Colitis and 26% had Crohn’s disease. Their mean age was 58 years, 39% male. Mean age at IBD diagnosis was 39 years, mean IBD disease duration 19 yrs. CBP (back pain greater than three months) was reported by 76%. Inflammatory back pain fulfilling Calin, Berlin, ASAS criteria was seen in 23%, 29%, and 15% respectively. In addition, 80% reported peripheral musculoskeletal pain. Self-reported personal history of enthesitis, reactive arthritis (ReA), acute anterior uveitis (AAU), skin psoriasis (PSO) and dactylitis were 50%, 30%, 24%, 15% and 0% respectively. Self-reported family history of IBD, ReA, PSO, axSpA and AAU were 60%, 36%, 22%, 11%, and 1% respectively.Ninety-one (53%) patients were MDP-positive and 82 (47%) patients were MDP-negative. The clinical characteristics associated with MDP (adjusted for age at invitation) were: the presence of inflammatory back pain using ASAS criteria [OR 8.84 (1.61,48.67); p=0.01], longer interval between symptom onset and gastroenterologist diagnosis of IBD [OR 1.09 (1.03,1.16); p=0.005], and use of rectal topical 5-aminosalicylic acid [OR 3.27 (1.11,9.68); p=0.03].Conclusion:Chronic back pain and peripheral musculoskeletal pain are common in a secondary care IBD population. In IBD patients, with back pain duration > 3 months and onset before 45 years, the presence of inflammatory back pain, longer diagnostic delay of IBD and the use of rectal topical 5-aminosalicylic acid were associated with a higher clinical probability of axSpA. The identification of these clinical features may not only improve the quality and specificity of Rheumatology referrals from Gastroenterology in this subgroup of patients but also lends real world evidence to current ASAS-endorsed recommendations for early referral of patients with a suspicion of axial spondyloarthritis.Disclosure of Interests:Chong Seng Edwin Lim Grant/research support from: AbbVie - Research support/grant but NOT for this study., Mark Tremelling: None declared, Louise Hamilton: None declared, Alexander Macgregor: None declared, Karl Gaffney Grant/research support from: AbbVie, Celgene, MSD, Novartis, Pfizer, and UCB Pharma, Consultant of: AbbVie, Celgene, MSD, Novartis, Pfizer, and UCB Pharma, Speakers bureau: AbbVie, Celgene, MSD, Novartis, Pfizer, and UCB Pharma

scholarly journals Identifying patients with axial spondyloarthritis in primary care: how useful are items indicative of inflammatory back pain?

2011 ◽  
Vol 70 (10) ◽  
pp. 1782-1787 ◽  
Author(s):  
A Braun ◽  
E Saracbasi ◽  
J Grifka ◽  
J Schnitker ◽  
J Braun
Keyword(s):  
Primary Care ◽  
Back Pain ◽  
Chronic Back Pain ◽  
Axial Spondyloarthritis ◽  
Age At Onset ◽  
Inflammatory Back Pain ◽  
Single Item ◽  
Inflammatory Drugs ◽  
Waking Up ◽  
Key Questions

BackgroundThe value of clinical items defining inflammatory back pain to identify patients with axial spondyloarthritis (SpA) in primary care is unclear.ObjectiveTo identify predictive clinical parameters for a diagnosis of axial SpA in patients with chronic back pain presenting in primary care.MethodsConsecutive patients aged <45 years (n=950) with back pain for >2 months who presented to orthopaedic surgeons (n=143) were randomised based on four key questions for referral to rheumatologists (n=36) for diagnosis.ResultsThe rheumatologists saw 322 representative patients (mean age 36 years, 50% female, median duration of back pain 30 months). 113 patients (35%) were diagnosed as axial SpA (62% HLA B27+), 47 (15%) as ankylosing spondylitis (AS) and 66 (21%) as axial non-radiographic SpA (nrSpA). Age at onset ≤35 years, improvement by exercise, improvement with non-steroidal anti-inflammatory drugs, waking up in the second half of the night and alternating buttock pain were identified as most relevant for diagnosing axial SpA by multiple regression analysis. Differences between AS and nrSpA were detected. No single item was predictive, but ≥3 items proved useful for good sensitivity and specificity by receiver operating characteristic modelling.ConclusionThis study shows that a preselection in primary care of patients with back pain based on a combination of clinical items is useful to facilitate the diagnosis of axial SpA.

scholarly journals P271 An analysis of short-term repeat MRI scans of vertebral corner lesions in suspected early axSpA: defining the prevalence and evolution of clinically significant spinal lesions without concurrent SIJ changes on imaging

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Saion Chatterjee ◽  
Helena Marzo-Ortega ◽  
Dennis McGonagle ◽  
Alexander N Bennett ◽  
Raj Sengupta
Keyword(s):  
Back Pain ◽  
Axial Spondyloarthritis ◽  
De Novo ◽  
Current Evidence ◽  
Inflammatory Back Pain ◽  
Short Term ◽  
Spinal Imaging ◽  
Asas Criteria ◽  
Mri Scans

Abstract Background MRI offers an enhanced opportunity to detect early spinal changes of axial spondyloarthritis (axSpA), by identifying characteristic inflammatory and structural lesions, so called Romanus lesions. These include bone marrow oedema lesions on the vertebral corners and fatty replacement of these lesions, both highly suggestive features of axSpA. Current evidence suggests that treatment of these lesions requires early biologic therapy, hence early identification is imperative. We evaluate the prevalence and variation of vertebral corner lesions on short-term repeat MRI scans in patients with suspected early axSpA. Methods 109 MRI scans were performed at baseline and at 4, 8 and 12-weeks on 30 patients with suspected axial spondyloarthritis, who fulfilled the ASAS inflammatory back pain criteria, and had normal sacroiliac joints (SIJs) on antero-posterior pelvis radiographs. The protocol included sagittal T1 and short-tau inversion recovery of the cervico-thoracic spine and thoracolumbar spine. Results 29 patients completed the study (66% were male, 72% HLA-B2-positive). All patients had ≥1 clinical spondyloarthritis (SpA) feature and 86% had ≥2. 13 patients used NSAIDs regularly over the 12-week study period. Overall, 40 corner lesions were present in participants at baseline scanning. 67 new vertebral corner lesion changes occurred at different time points over the follow-up period compared to baseline. 43 changes were new or worsening lesions, while 24 changes were an improvement or resolution of a lesion. 48.6% (14/29) of patients had a minimum of 1 corner lesion present at baseline. 78.5% (11/14) of patients with baseline corner lesions experienced either a decrease/improvement or increase/progression of spinal corner lesions. 20.7% (6/29) of patients demonstrated transient corner lesions at baseline or follow-up with resolution by the 12-week scan (likely artefact). 5/29 patients met spinal imaging criteria suggestive of AS (3 at baseline, 1 only transiently at 1 month, and 1 which persisted from interval scanning). At 12-weeks, 13.8% of patients had at least 3 concomitant baseline or de-novo vertebral corner lesions present (minimum number needed for diagnostic significance). 75% of these patients did not have evidence of concomitant SIJ changes (10.3% of all patients). HLA-B27 status, gender, NSAID use, and number of SpA features were not associated with corner lesion development or improvement. Conclusion Approximately half of all patients who meet ASAS criteria for inflammatory back pain, but do not meet ASAS criteria for axSpA, demonstrated at least 1 vertebral corner lesion on MRI scan at baseline, which may represent artefact or a prelude to future disease progression. 13.8% of patients had at least 3 concomitant baseline or de-novo vertebral corner lesions present on MRI at the conclusion of 12-weeks of follow-up. In cases of suspected axSpA with negative SIJ MRI imaging, 10.3% of patients had significant spinal evidence of axSpA on MRI, highlighting the importance of spinal imaging and monitoring as part of the diagnostic work-up for axSpA. Disclosures S. Chatterjee None. H. Marzo-Ortega None. D. McGonagle None. A. Bennett None. R. Sengupta None.

What is axial spondyloarthritis? A latent class and transition analysis in the SPACE and DESIR cohorts

2020 ◽  
Vol 79 (3) ◽  
pp. 324-331 ◽  
Author(s):  
Alexandre Sepriano ◽  
Sofia Ramiro ◽  
Désirée van der Heijde ◽  
Floris van Gaalen ◽  
Pierre Hoonhout ◽  
...  
Keyword(s):  
At Risk ◽  
Back Pain ◽  
Latent Class ◽  
Axial Spondyloarthritis ◽  
Positive Family History ◽  
Classification Criteria ◽  
Hla B27 ◽  
Transition Analysis ◽  
Latent Constructs ◽  
Asas Classification Criteria

ObjectivesTo gain expert-judgement-free insight into the Gestalt of axial spondyloarthritis (axSpA), by investigating its ‘latent constructs’ and to test how well these latent constructs fit the Assessment of SpondyloArthritis international Society (ASAS) classification criteria.MethodsTwo independent cohorts of patients with early onset chronic back pain (SPondyloArthritis Caught Early (SPACE)) or inflammatory back pain (IBP) (DEvenir des Spondylarthopathies Indifférenciées Récentes (DESIR)) were analysed. Latent class analysis (LCA) was used to estimate the (unobserved) potential classes underlying axSpA. The best LCA model groups patients into clinically meaningful classes with best fit. Each class was labelled based on most prominent features. Percentage fulfilment of ASAS axSpA, peripheral SpA (pSpA) (ignoring IBP) or both classification criteria was calculated. Five-year data from DESIR were used to perform latent transition analysis (LTA) to examine if patients change classes over time.ResultsSPACE (n=465) yielded four discernible classes: ‘axial’ with highest likelihood of abnormal imaging and HLA-B27 positivity; ‘IBP+peripheral’ with 100% IBP and dominant peripheral symptoms; ‘at risk’ with positive family history and HLA-B27 and ‘no SpA’ with low likelihood for each SpA feature. LCA in DESIR (n=576) yielded similar classes, except for the ‘no-SpA’. The ASAS axSpA criteria captured almost all (SPACE: 98%; DESIR: 93%) ‘axial’ patients, but the ‘IBP+peripheral’ class was only captured well by combining the axSpA and pSpA criteria (SPACE: 78%; DESIR: 89%). Only 4% of ‘no SpA’ patients fulfilled the axSpA criteria in SPACE. LTA suggested that 5-year transitions across classes were unlikely (11%).ConclusionThe Gestalt of axSpA comprises three discernible entities, only appropriately captured by combining the ASAS axSpA and pSpA classification criteria. It is questionable whether some patients with ‘axSpA at risk’ will ever develop axSpA.

scholarly journals Gender Differences in Disease Activity and Impact in Axial Spondyloarthritis

2021 ◽  
pp. jrheum.210564
Author(s):  
Ying-Ying Leung
Keyword(s):  
Gender Differences ◽  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
International Society ◽  
Axial Spondyloarthritis ◽  
Classification Criteria ◽  
Inflammatory Back Pain

Ankylosing spondylitis (AS), characterized by inflammatory back pain and sacroiliitis on radiography, was traditionally considered a condition predominant in men. Since the introduction of the 2009 Assessment in Spondyloarthritis international Society classification criteria1 aiming to facilitate earlier classification of cases without radiographic sacroiliitis, more women have been classified as having axial spondyloarthritis (axSpA).

AB0697 PERFORMANCE OF DIFFERENT CRITERIA SETS FOR INFLAMMATORY BACK PAIN IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS IN DEMOCRATIC REPUBLIC OF CONGO

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1644-1645
Author(s):  
P. Lebughe ◽  
K. De Vlam ◽  
R. Westhovens ◽  
J. M. Mbuyi-Muamba ◽  
J. J. Malemba
Keyword(s):  
Back Pain ◽  
Clinical Judgment ◽  
Democratic Republic ◽  
Axial Spondyloarthritis ◽  
Democratic Republic Of Congo ◽  
University Hospital ◽  
Inflammatory Back Pain ◽  
Research Support ◽  
Asas Criteria ◽  
The University

Background:Inflammatory back pain (IBP) is the most prominent clinical feature for an early diagnosis of axial spondyloarthritis. The performance of the criteria sets for IBP has not yet been assessed in clinical practice in the Democratic Republic of Congo (DRC).Objectives:To assess and to compare the performance of different IBP criteria sets in axial spondyloarthritis (SpA) outpatients attending the rheumatology unit of the University Hospital of Kinshasa, DRC.Methods:One hundred and eight Congolese outpatients with axial SpA defined by rheumatologist’s clinical judgment were included in the spondyloarthritis cohort of the University Hospital of Kinshasa from March 1st2015 to February 28, 2017. Calin criteria, Berlin criteria and ASAS criteria sets for IBP were performed to assess their performance against clinical judgment. Detailed history, clinical examination and imaging of sacroiliac joints by plain radiography were obtained. Sacroiliac joint radiographic lesions were scored with the modified New York criteria. Magnetic resonance imaging and HLA B27 were not performed. Fifty additional patients with a diagnosis of chronic (>3 months) mechanical low back pain (MLBP) were included as control group. The performance of each item and different criterias was evaluated using sensitivity, specificity, and likelihood ratio (LR). Baseline characteristics of the mechanical and inflammatory back pain cohorts were compared with chi-square or Student t tests as appropriate.Results:The mean age was 43.8±15.1 years in SpA patients versus 62.4±9.1 years in controls (MLBP patients) with respective sex ratio (M/F) of 1/0.8 and 1/2.1. There were significantly more male patients in the ankylosing spondylitis (AS) group than in the non-radiographic axial spondyloarthritis group (p<0.01). Among the criteria sets, Calin criteria showed the best sensitivity (92.6%) while the Berlin criteria showed the best specificity (97.6%) in the detection of IBP patients. The new ASAS criteria for IBP compared to the two previous criteria sets did not show good sensitivity nor specificity (sensivity 80%, specificity 62%, LR+ 1.05 (0.90 – 1.22), LR- 0.52 (0.39 – 0.69), 95%CI).Conclusion:The Calin criteria set would be useful for epidemiological and clinical studies in DRC. The ASAS criteria set for IBP is not better than other criteria sets in the screening of IBP for Congolese patients with axSpA.References:[1]Heuft-Dorenbosch L, Landewe R, Weijers R et al.Performance of various criteria sets in patients with inflammatory back pain of short duration; the Maastricht early spondyloarthritis clinic Ann Rheum Dis 2007;66:92–98. doi: 10.1136/ard.2006.053918[2]Michele C. Battié M, LINDA J. CARROLL et al. Preliminary Validation of a Self-reported Screening Questionnaire for Inflammatory Back Pain. J Rheumatol 2012;39;822-829[3]Poddubnyy D, Callhoff J, Spiller I, et al. Diagnostic accuracy of inflammatory back pain for axial spondyloarthritis in rheumatological care.RMD Open. 2018;4(2):e000825. Published 2018 Dec 5. doi:10.1136/rmdopen-2018-000825[4]Wang R, Crowson CS, Wright K, Ward MM. Clinical Evolution in Patients With New-Onset Inflammatory Back Pain: A Population-Based Cohort Study.Arthritis Rheumatol. 2018;70(7):1049–1055. doi:10.1002/art.40460Disclosure of Interests:Pierrot Lebughe: None declared, Kurt de Vlam Grant/research support from: Celgene, Eli Lilly, Pfizer Inc, Consultant of: AbbVie, Eli Lilly, Galapagos, Johnson & Johnson, Novartis, Pfizer Inc, UCB, Rene Westhovens Grant/research support from: Celltrion Inc, Galapagos, Gilead, Consultant of: Celltrion Inc, Galapagos, Gilead, Speakers bureau: Celltrion Inc, Galapagos, Gilead, Jean-Marie Mbuyi-Muamba: None declared, Jean-Jacques Malemba: None declared

scholarly journals Do patients with axial spondyloarthritis with radiographic sacroiliitis fulfil both the modified New York criteria and the ASAS axial spondyloarthritis criteria? Results from eight cohorts

2019 ◽  
Vol 78 (11) ◽  
pp. 1545-1549 ◽  
Author(s):  
Anne Boel ◽  
Anna Molto ◽  
Désirée van der Heijde ◽  
Adrian Ciurea ◽  
Maxime Dougados ◽  
...  
Keyword(s):  
New York ◽  
Back Pain ◽  
Ankylosing Spondylitis ◽  
International Society ◽  
Axial Spondyloarthritis ◽  
Age At Onset ◽  
Complete Information ◽  
Asas Criteria ◽  
Radiographic Criterion ◽  
Almost All

BackgroundPatients with spondyloarthritis with radiographic sacroiliitis are traditionally classified according to the modified New York (mNY) criteria as ankylosing spondylitis (AS) and more recently according to the Assessment of SpondyloArthritis international Society (ASAS) criteria as radiographic axial spondyloarthritis (r-axSpA).ObjectiveTo investigate the agreement between the mNY criteria for AS and the ASAS criteria for r-axSpA and reasons for disagreement.MethodsPatients with back pain ≥3 months diagnosed as axSpA with radiographic sacroiliitis (mNY radiographic criterion) were selected from eight cohorts (ASAS, Esperanza, GESPIC, OASIS, Reuma.pt, SCQM, SPACE, UCSF). Subsequently, we calculated the percentage of patients who fulfilled the ASAS r-axSpA criteria within the group of patients who fulfilled the mNY criteria and vice versa in six cohorts with complete information.ResultsOf the 3882 patients fulfilling the mNY criteria, 93% also fulfilled the ASAS r-axSpA criteria. Inversely, of the 3434 patients fulfilling the ASAS r-axSpA criteria, 96% also fulfilled the mNY criteria. The main cause for discrepancy between the two criteria sets was the reported age at onset of back pain.ConclusionAlmost all patients with axSpA with radiographic sacroiliitis fulfil both ASAS and mNY criteria, which supports the interchangeable use of the terms AS and r-axSpA.

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

2017 ◽  
Vol 76 (6) ◽  
pp. 1086-1092 ◽  
Author(s):  
Z Ez-Zaitouni ◽  
P A C Bakker ◽  
M van Lunteren ◽  
I J Berg ◽  
R Landewé ◽  
...  
Keyword(s):  
Back Pain ◽  
Human Leucocyte Antigen ◽  
Chronic Back Pain ◽  
Axial Spondyloarthritis ◽  
Classification Criteria ◽  
Hla B27 ◽  
Sacroiliac Joints ◽  
Asas Classification Criteria ◽  
Early Cohort ◽  
Made In

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 <45 years) were analysed. All patients underwent full diagnostic workup including MRI of the sacroiliac joints (MRI-SI) and radiograph of sacroiliac joints (X-SI). For each patient, the total number of SpA features excluding sacroiliac imaging and human leucocyte antigen B27 (HLA-B27) status was calculated.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.

scholarly journals Performance of Different Criteria Sets for Inflammatory Back Pain in Radiographic and Nonradiographic Axial Spondyloarthritis

2021 ◽  
Author(s):  
Md. Toufiqul Islam ◽  
Mohammad Imtiaz Sultan ◽  
Sujan Rudra
Keyword(s):  
Back Pain ◽  
Axial Spondyloarthritis ◽  
Positive Likelihood Ratio ◽  
High Sensitivity ◽  
Inflammatory Back Pain ◽  
Care Practice ◽  
Second Phase ◽  
Health And Nutrition ◽  
Asas Criteria ◽  
Expert Criteria

Introduction: It is important to recognise inflammatory back pain (IBP) for early diagnosis of ankylosing spondylitis (AS). The aims of this study were to develop a valid, reliable Bengali IBP tool and to assess the performance of different IBP criteria sets, including Calin, Berlin set 8a and 7b, and new Assessment of SpondyloArthritis International Society (ASAS) expert criteria, in radiographic axial spondyloarthritis (axSpA) and nonradiographic axSpA. Method: This case-control study was performed in three phases. The first phase involved development of an IBP tool by adding the fifth parameter of ASAS expert criteria to the National Health and Nutrition Examination Survey (NHANES) 2009–2010 arthritis questionnaires; the second phase assessed reliability by test-retest statistics among 87 participants at a 5-day interval. Finally, according to the imaging arm of ASAS axSpA classification criteria, 50 patients with axSpA were included as cases while 50 patients with chronic mechanical back pain (MBP) were included as a control. Results: The presence of IBP with SpA versus patients with MBP, detected by Calin criteria, were 76.0% versus 10.0%, by Berlin 8a were 72.0% versus 6.0%, by Berlin 7b were 58.0% versus 12.0%, and by ASAS were 64.0% versus 18.0%, respectively. Results suggested the Calin criteria set has the highest sensitivity (76.0%) and Berlin set 8a has the highest specificity (78.9%) in the differentiation of IBP from MBP. Conclusion: The performance of the new ASAS criteria was analogous to the other existing criteria sets. The highest positive likelihood ratio and odds ratio were found for Berlin set 8a criteria. The Berlin set 8a criteria can still be used in primary care practice at the first screening because of high sensitivity.

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