SIGNIFICANCE OF IN EARLY DIAGNOSIS OF SPONDYLOARTHROPATHY
Journal
Македонски медицински преглед = Macedonian Medical Review
Date Issued
2019
Author(s)
Abstract
Introduction. Very often late diagnosis in spondylitis
ankylosans (SA) in the period between 5 to 10 years is
due to unstandardized diagnostic method besides established diagnostic criteria. But, they are very restrictive
and not practical for early diagnosis of SAbecause
they are based on proved radiographic changes.
Aim. Sacroiliitis (SI) as a sole entity rarely exists, usually
is a part of the diagnostic mosaic of SA and related spondyloarthropathies (SpA). Surely proved SI clinically and
radiographically means sure diagnosis of SA, especially
in the early stage of the disease.
Methods. A highly selective group of patients with SA
was followed in the period of one year: group of 23
patients (pts) with unconvincing radiographic changes
for SA from 1-2
°
and group of 21 pts without radiographic
changes i.e. 0°. Beside SA, both groups fulfilled at least
another from the listed conditions: 1.oligoarthritis; 2. enthesitis; 3. iridocyclitis; 4. positive family history for SA; 5.
positive antigen HLA-B27 and 6. elevated ESR > 30mm/h.
Results. After one-year observational period 11/21 pts
in group A were with SA. In group B only 6/23 pts
were with SA; the others were transformed in different
directions: 4/23 in the group of spondyloarthropathies
(SpA)-2 pts with psoriatic spondyloarthropathy (PsSpA),
1 patient with Reiter syndrome (RS) and 1 patient with
entericspondyloarthropathy (ESpA). The remaining
8/22 pts were still undefined SpA.
Conclusion. Our results showed that defining of SA
was crucial in the diagnosis of SA. The fact that most
of the cases with authentic SA were in group A with minimal radiographic changes from 1-2° in comparison
with group B without radiographic changes showed
the necessity of using other imaging techniques (scan,
MRI) for earlier detection of SI in the so called preradiographic stage which lasts 2-4 years, when radiographic findings are absent. Clinical (symptomatic) SI without radiographic changes according to the findings of
pts in group B gives a possibility for overlap to other
entities in the group of SpA.
ankylosans (SA) in the period between 5 to 10 years is
due to unstandardized diagnostic method besides established diagnostic criteria. But, they are very restrictive
and not practical for early diagnosis of SAbecause
they are based on proved radiographic changes.
Aim. Sacroiliitis (SI) as a sole entity rarely exists, usually
is a part of the diagnostic mosaic of SA and related spondyloarthropathies (SpA). Surely proved SI clinically and
radiographically means sure diagnosis of SA, especially
in the early stage of the disease.
Methods. A highly selective group of patients with SA
was followed in the period of one year: group of 23
patients (pts) with unconvincing radiographic changes
for SA from 1-2
°
and group of 21 pts without radiographic
changes i.e. 0°. Beside SA, both groups fulfilled at least
another from the listed conditions: 1.oligoarthritis; 2. enthesitis; 3. iridocyclitis; 4. positive family history for SA; 5.
positive antigen HLA-B27 and 6. elevated ESR > 30mm/h.
Results. After one-year observational period 11/21 pts
in group A were with SA. In group B only 6/23 pts
were with SA; the others were transformed in different
directions: 4/23 in the group of spondyloarthropathies
(SpA)-2 pts with psoriatic spondyloarthropathy (PsSpA),
1 patient with Reiter syndrome (RS) and 1 patient with
entericspondyloarthropathy (ESpA). The remaining
8/22 pts were still undefined SpA.
Conclusion. Our results showed that defining of SA
was crucial in the diagnosis of SA. The fact that most
of the cases with authentic SA were in group A with minimal radiographic changes from 1-2° in comparison
with group B without radiographic changes showed
the necessity of using other imaging techniques (scan,
MRI) for earlier detection of SI in the so called preradiographic stage which lasts 2-4 years, when radiographic findings are absent. Clinical (symptomatic) SI without radiographic changes according to the findings of
pts in group B gives a possibility for overlap to other
entities in the group of SpA.
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