4.5 Article

Prevalence of Nonradiographic Sacroiliitis in Patients With Psoriatic Arthritis: A Real-life Observational Study

期刊

JOURNAL OF RHEUMATOLOGY
卷 48, 期 7, 页码 1014-1021

出版社

J RHEUMATOL PUBL CO
DOI: 10.3899/jrheum.200961

关键词

MRI; psoriatic arthritis; sacroiliitis; spondyloarthropathy

资金

  1. AbbVie

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The study found that the prevalence of active sacroiliitis in a real-life sample of patients with PsA was 26%, with a lower prevalence of nonradiographic sacroiliitis (11%) compared to radiographic sacroiliitis (28.7%) in patients with longer disease duration. Inflammatory back pain was not a sensitive indicator for early-stage sacroiliitis.
Objective. To establish the prevalence of nonradiographic sacroiliitis within a real-life sample of patients with psoriatic arthritis (PsA), using pelvic radiographs and magnetic resonance imaging (MRI) of sacroiliac joints (SIJs). Methods. This cross-sectional study included 107 consecutive adults with PsA (Classification Criteria for Psoriatic Arthritis criteria). Participants completed clinical and laboratory evaluation, pelvic radiographs scored for radiographic sacroiliitis according to the modified New York (mNY) criteria, and noncontrast MRI of SIJs, scored by the Berlin score and categorized into active sacroiliitis using the 2016 Assessment of Spondyloarthritis international Society (ASAS) criteria and the presence of structural sacroiliitis. Results. Radiographic sacroiliitis/mNY criteria were detected in 28.7% (n = 29), confirmed by MRI- detected structural lesions in 72.4% (n = 21). Active sacroiliitis was detected by MRI in 26% (n = 28) of patients, with 11% (n = 11) qualifying for nonradiographic sacroiliitis. Patients with radiographic and nonradiographic sacroiliitis had similar clinical characteristics, except for a longer duration of psoriasis (PsO) and PsA in the radiographic subgroup (PsO: 23.8 +/- 12.5 vs 14.1 +/- 11.7 yrs, P = 0.03; PsA: 12.3 +/- 9.8 vs 4.7 +/- 4.5 yrs, P = 0.02, respectively). Inflammatory back pain (IBP) was reported in 46.4% (n = 13) with active sacroiliitis and 27% (n = 3) with nonradiographic sacroiliitis. The sensitivity of IBP for detection of nonradiographic sacroiliitis was low (27%) and moderate for radiographic sacroiliitis (52%), whereas specificity ranged from 72% to 79% for radiographic and nonradiographic sacroiliitis, respectively. Conclusion. The prevalence of active sacroiliitis among a real-life population of patients with PsA was 26%. However, the prevalence of nonradiographic sacroiliitis was low (11%) compared to the radiographic sacroiliitis (28.7%) seen in patients with longer disease duration. IBP was not a sensitive indicator for the presence of early-stage sacroiliitis that was commonly asymptomatic.

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