engleski

CLINICAL AND IMAGING CORRELATES IN PATIENTS WITH SPONDYLOARTHROPATHIES

Background: Spondyloarthropathies (SpA) in general are a group of inflammatory rheumatic diseases comprising a number of diagnostic entities: ankylosing spondylitis (AS), characterised by predominant axial skeletal involvement and oligoarthritic component with advanced radiographic sacroiliac joint modifications ; reactive arthritis (ReA), characterised by an antecedent triggering infection ; a subset of psoriatic arthritis (PsA) ; arthritis associated with idiopathic inflammatory bowel disease (AIBD) and undifferentiated SpA (uSpA). Objectives: The aim of this study was to investigate the relationship between clinical and imaging correlates and parameters of SpA activity, seasonal oscillations and response to DMARD treatement. Methods: 74 examinees were investigated (56 F: 28.6 &plusmn ; ; ; 20.4 SD ; 18 M: 35.6 &plusmn ; ; ; 18.6 SD) from March 2000 till December 2001. To examine the activity of inflammatory disease we used clinical parameters, laboratory findings, Bath Ankylosing Spondilytis Disease Activity Index (BASDAI), Bath Ankylosing Spondilytis Functional Index (BASFI), Visual Analog Scale of pain (VASp) and VAS of stiffnes (VASs). Results: A statistically significant increase in clinical manifestation of inflammation activity was proved in Septemeber (p<0, 0088) and October (p < 0.0292) as well as in March (p<0, 0292) and April ( p<0.061). Clinical activity measurements showed increased correlation especially between Mennell sign (Ms) vs. VASs: p < 0.0001 ; Ms vs. respiratory index (RIx) (p < 0.0001) ; Ms vs. x - ray of sacroiliac (SI) joints ( p < 0.0001) ; Ms vs. SI scintigraphy index (SSIIx) ( p < 0.0001) ; RiIx vs.VASs: ( p < 0.0249) ; SSIIx ( p < 0.0032) ; VASp vs. VASs: ( p < 0.0001). DMARD (Sulphasalazine) showed improvement in 95.37% of examinees ( p < 0.0001). Conclusion: SpA activity appears to be related to seasonal variations. The analyses of clinical and imaging correlates stress the importance of objective examination (Mennell sign, VASp and VASs) as well as radiologic and scintigraphy findings of SI joints. DMARD (Sulphasalazine) showed effective response and tolerance. Long term control of symptoms will require rationalisation of diagnostic procedures, drug medications and better health assessment quality. Evaluation of SpA activity and annual oscillations based on this study need further monitoring. References: Clegg DO ; et al:Arthritis Rheum 1999 Nov ; 42(11):2325-9. Toussirot E ; Wendling D: Drugs 1998 Aug ; 56(2):225-40. Jones SD et al:J Rheumatol 1996 Mar ; 23(3):487-90. Ward MM: J Rheumatol 1999 Mar ; 26(3):546-50. Smolen JS:Scand J Rheumatol Suppl 1999 ; 112:15-21.

Spondyloarthropathies; seasonal variations; annual oscillations; SpA activity

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