Manubriosternal Joint Involvement as a Presenting Feature of Axial Spondyloarthritis

BackgroundDisease activity may change over time in axial spondyloarthritis (axSpA). The objectives were to identify patterns of disease activity evolution in patients with early axSpA.MethodsPatients from the prospective early axSpA cohort (DEvenir des Spondyloarthrites Indifférenciées Récentes (DESIR)) who fulfilled the Assessment in SpondyloArthritis Society (ASAS) criteria for axSpA at baseline and with at least three Ankylosing Spondylitis Disease Activity Score (ASDAS) values available over the 3 years of follow-up were analysed. Statistical analyses: trajectories were estimated by group-based trajectory modelling; predisposing baseline factors for such trajectories were identified by univariate and multivariable multinomial (logit) regression; work disability over time was compared between the trajectories by Cox hazard model.ResultsIn all, 370 patients were analysed: mean disease duration was 1.6 (±0.9) years. The five distinct trajectories of disease activity over the 3 years were (t1) ‘persistent moderate disease activity’ (n=134 (36.2%)); (t2) ‘persistent inactive disease’ (n=66 (17.8%); (t3) ‘changing from very high disease activity to inactive disease’ ((n=29 (7.8%)); (t4) ‘persistent high disease activity’ (n=126 (34.1%)) and (t5) ‘persistent very high disease activity’ (n=15 (4.1%)). After adjustment for other characteristics, t2 was associated with a white-collar job (OR=2.6 (95% CI 1.0 to 6.7)) and t3 with male gender (OR=7.1 (1.6 to 32.2)), higher education level (OR=9.4 (1.4 to 63.4)) and peripheral joint involvement (OR=6.2 (1.23 to 31.32)). Patients from (t4) and (t5) were more often declared work disabled over follow-up (HR=5.2 (1.5 to 18.0) and HR=8.0 (1.3 to 47.9), respectively).ConclusionsTrajectory modelling of disease activity was feasible in early axSpA: more than 30% patients (141/370) were in a trajectory with a persistent high disease activity. Persistent high disease activity trajectories were significantly associated with consequences on work.Trial registration numberNCT01648907.

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Time course of radiographic hip joint changes in patients with early axial spondyloarthritis

Modern Rheumatology Journal ◽

10.14412/1996-7012-2021-1-46-50 ◽

2021 ◽

Vol 15 (1) ◽

pp. 46-50

Author(s):

E. M. Agafonova ◽

D. G. Rumyantseva ◽

A. V. Smirnov ◽

Sh. Erdes

Keyword(s):

Hip Joint ◽

Time Course ◽

Axial Spondyloarthritis ◽

Disease Onset ◽

Underlying Disease ◽

Joint Involvement ◽

Base Line ◽

Radiological Progression ◽

The Mean

The diagnosis of coxitis remains one of the most difficult problems in the management of patients with axial spondyloarthritis (axSpA). In Russia, almost every two patients with axSpA were found to have hip joint (HJ) damage. However, until a certain time, there have been no methods to estimate the rate of progression of radiographic HJ changes in clinical practice. We have previously developed a formula for calculating the rate of coxitis progression, which simplifies the assessment of radiographic HJ changes and allows a physician to make a timely decision about changing therapy if rapidly progressing coxitis is detected.Objective: to estimate the rate of radiological progression of coxitis during a 24-month follow-up of patients with early axSpA.Patients and methods. Examinations were made in 38 patients (20 women and 18 men) who had been followed up for at least 2 years without radiographic and ultrasound signs of HJ joint involvement. The patients' mean age was 28.8±5.5 years; the disease duration was 22.7±15.7 months. HLA-B27 was positive in 35 (92%) patients. The summary stage of radiographic coxitis (ssRC) was used to assess HJ damage; the previously developed formula was applied to estimate the rate of radiological progression of coxitis (R-rpC).Results and discussion. The median cervical-capsular distance (CCD) was 5.2 mm at baseline and 4.9 mm at 2 years (p7 mm increase in the CCD. The mean ssRC was 0.34±0.75 scores at base line, 0.86±0.78 scores at 1 year; and this indicator increased up to 1.24±1.36 scores at 2 years (p=0.004). During 2 years of follow-up, there was no coxitis progression (the difference between ssRC2 and ssRC1 was 0) in 24 (63%) patients; ΔssRC increased by 1 score in 5 (13%); by 2 scores in 6 (16%), and by 4 scores in 3 (8%). On patient inclusion to the investigation, R-rpC averaged 0.5 (it was conventionally assumed that patients had no signs of HJ damage at the disease onset (ssRC=0). During therapy for the underlying disease, the mean R-rpC was 0.3 and 0.2 score/year within the first and second years, respectively. The mean R-rpC in the ΔssRC >0 group was as many as 0.85 score/year at one-year follow-up and 0.53 score/year at two-year follow-up.Conclusion. The developed procedure for estimating the progression of coxitis using ssRC is easy to use and can identify patients at high risk for coxitis progression.

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Magnetic Resonance Imaging Findings of Manubriosternal Joint Involvement in SAPHO Syndrome

Clinical Rheumatology ◽

10.1007/s100670170073 ◽

2001 ◽

Vol 20 (3) ◽

pp. 232-233 ◽

Cited By ~ 9

Author(s):

K. Laiho ◽

I. Soini ◽

J. Martio

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Sapho Syndrome ◽

Joint Involvement ◽

Imaging Findings ◽

Resonance Imaging ◽

Manubriosternal Joint

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Symptomatic manubriosternal joint involvement in rheumatoid arthritis.

Annals of the Rheumatic Diseases ◽

10.1136/ard.48.6.516 ◽

1989 ◽

Vol 48 (6) ◽

pp. 516-517 ◽

Cited By ~ 5

Author(s):

A Doube ◽

A K Clarke

Keyword(s):

Rheumatoid Arthritis ◽

Joint Involvement ◽

Manubriosternal Joint

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Identifying Persons with Axial Spondyloarthritis At Risk of Poor Work Outcome: Results from the British Society for Rheumatology Biologics Register

The Journal of Rheumatology ◽

10.3899/jrheum.180477 ◽

2018 ◽

Vol 46 (2) ◽

pp. 145-152 ◽

Cited By ~ 6

Author(s):

Gary J. Macfarlane ◽

Joanna Shim ◽

Gareth T. Jones ◽

Karen Walker-Bone ◽

Ejaz Pathan ◽

...

Keyword(s):

Axial Spondyloarthritis ◽

Work Productivity ◽

British Society ◽

Joint Involvement ◽

Activity Impairment ◽

Work Outcome ◽

Increased Risk ◽

Modifiable Factors ◽

Patient Reported ◽

Biologics Register

Objective.First, to test the hypothesis that, among working patients with axial spondyloarthritis (axSpA), those who report issues with reduced productivity at work (presenteeism) are at higher risk of work absence (absenteeism), and patients who report absenteeism are at higher risk of subsequently leaving the workforce. Second, to identify characteristics of workers at high risk of poor work outcome.Methods.The British Society for Rheumatology Biologics Register in Ankylosing Spondylitis has recruited patients meeting Assessment of Spondyloarthritis international Society criteria for axSpA from 83 centers. Data collection involved clinical and patient-reported measures at recruitment and annually thereafter, including the Work Productivity and Activity Impairment scale. Generalized estimating equations were used to identify factors associated with poor work outcomes.Results.Of the 1188 participants in this analysis who were working at recruitment, 79% reported some presenteeism and 19% some absenteeism in the past week owing to their axSpA. Leaving employment was most strongly associated with previous absenteeism (RR 1.02 per % increase in absenteeism, 95% CI 1.01–1.03), which itself was most strongly associated with previous presenteeism, a labor-intensive job, and peripheral joint involvement. High disease activity, fatigue, a labor-intensive job, and poorer physical function were all independently associated with future presenteeism.Conclusion.Clinical and patient-reported factors along with aspects of work are associated with an increased risk of axSpA patients having a poor outcome in relation to work. This study has identified modifiable factors as targets, facilitating patients with axSpA to remain productive at work.

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