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Costovertebral joint involvement in patients with axial spondyloarthritis - 21/06/23

Doi : 10.1016/j.jbspin.2023.105546 
Seung Min Jung a, Moon-Young Kim b, Yeon Sik Hong b, Sung-Hwan Park c, Kwi Young Kang b,
a Division of Rheumatology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea 
b Division of Rheumatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea 
c Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea 

Corresponding author at: Division of Rheumatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #56, Dongsu-Ro, Bupyung-Gu, Incheon, Republic of Korea.Division of Rheumatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea#56, Dongsu-Ro, Bupyung-GuIncheonRepublic of Korea

Highlights

Costovertebral joint is commonly involved in axial spondyloarthritis (axSpA).
Costovertebral joint involvement is associated with disease features of axSpA.
Low-dose CT is recommended for evaluating costovertebral joint abnormalities.

Il testo completo di questo articolo è disponibile in PDF.

Abstract

Objectives

To evaluate costovertebral joint involvement in patients with axial spondyloarthritis (axSpA) and to assess its association with disease features.

Methods

We included 150 patients from the Incheon Saint Mary's axSpA observational cohort who underwent whole spine low-dose computed tomography (ldCT). Costovertebral joint abnormalities were scored by two readers on a scale of 0–48 based on the presence or absence of erosion, syndesmophyte, and ankylosis. The interobserver reliability of costovertebral joint abnormalities was assessed using intraclass correlation coefficients (ICCs). Associations between costovertebral joint abnormality scores and clinical variables were evaluated using a generalized linear model.

Results

Two independent readers found costovertebral joint abnormalities in 74 (49%) patients and 108 (72%) patients. The ICCs of scores for erosion, syndesmophyte, ankylosis, and total abnormality were 0.85, 0.77, 0.93, and 0.95, respectively. For both readers, total abnormality score was correlated with age, symptom duration, Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath AS functional index (BASFI), CT syndesmophyte score (CTSS), and number of bridging spines. Multivariate analyses showed age, ASDAS, CTSS to be independently associated with total abnormality scores in both readers. The frequency of ankylosed costovertebral joint was 10.2% (reader 1) and 17.0% (reader 2) in patients without radiographic syndesmophytes (n=62), and 10.3% (reader 1) and 17.2% (reader 2) in patients without radiographic sacroiliitis (n=29).

Conclusions

Costovertebral joint involvement was common in patients with axSpA, even in the absence of radiographic damage. LdCT is recommended for evaluating structural damage in patients with clinically suspected costovertebral joint involvement.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Axial spondyloarthritis, Costovertebral joint, Thoracic spine, Low-dose computed tomography, Syndesmophyte


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© 2023  Société française de rhumatologie. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 90 - N° 4

Articolo 105546- luglio 2023 Ritorno al numero
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