X-Ray Spine Lesions Are Rare and Not Discriminant for Axial Spondyloarthritis Recognition in Patients with Recent Onset Chronic Back Pain

Anna Molto¹, Laure Gossec², Violaine Foltz², Romain Beaufort³, Jean Denis Laredo⁴, Pascal Richette⁵, Philippe Dieude⁶, Philippe Goupille⁷, Antoine Feydy⁸ and Maxime Dougados⁹, ¹Hôpital Cochin, Department of Rheumatology, Paris Descartes University, Paris, France, ²UPMC University Paris 06, Pitié-Salpétrière Hospital, Paris, France, ³Private Practice,, Paris, France, ⁴Radiology Department, Lariboisière Hospital, Paris, France, ⁵Rheumatology Department, Université Paris Diderot, Paris, France, ⁶Université Paris-Diderot, Paris, France, ⁷Université François-Rabelais, Tours, France, ⁸Univ. Paris Descartes, PRES Sorbonne Paris Cité, Service de radiologie B, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France, Paris, France, ⁹Department of Rheumatology, Paris Descartes University, Hôpital Cochin, Paris, France

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: performance, spine involvement, spondylarthritis and x-ray

Session Information

Date: Sunday, November 5, 2017

Title: Spondyloarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: only very scarce data is available regarding the prevalence of spine Xrays abnormalities suggestive of axial Spondyloarthritis (axSpA) in patients with recent onset mechanical chronic back pain (CBP).

Objective: To evaluate the frequency of spine X-ray abnormalities suggestive of axSpA in a non-axSpA CBP population and to compare its prevalence to an recent onset axSpA cohort.

Methods:

Methods : Study design: Observational cross-sectional national multicentre study. Patients: a) Recent onset axSpA patients: first, a sample of 100 patients representative in terms of imaging abnormalities of the global DESIR ⁽¹⁾ recent onset axSpA cohort (> 3 months but <3 years), based on the results of the previously published central reading of baseline films of DESIR⁽²⁾ were selected (e.g. 21% of patients fulfilling the modified NY criteria (mNY)). b) Recent onset CBP patients: consecutive in- and outpatients consulting for recent (>3months but <5years) mechanical CBP, initiating before the age of 45y and with a maximum age of 50y, in four tertiary care Hospitals were included in the study. Imaging: Full spine Xrays were performed in both groups with an identical protocol. Central reading: an experienced reader (AM) centrally read X-ray films, blinded for clinical diagnosis. Statistical analysis: Number of lesions suggestive of axSpA were compared in both groups.

Results: A total of 98 patients with recent onset CBP were included, and compared to 100 recent onset axSpA patients. Age and gender were comparable (mean (SD) 36.2 (9.9) vs. 32.2 (8.7)y, and 41.8% and 45% males, in the CBP vs. axSpA groups, respectively). Prevalence of spine lesions was globally very low, and only squaring was significantly more frequent in the axSpA group.

	CBP (N=95)	SpA (N=100)	p
Number of erosions	0.4 (0.8)	0.3 (0.5)	NS
Number of sclerosis lesions	0.4 (1.6)	0.5 (1.4)	NS
Number of squarring lesions	0.01 (0.1)	0.2 (0.8)	0.037
mSASSS*	2.0 (14.5) n=89	2.2 (15.1) n=91	NS
Number of patients with at least one full bone bridge	2 (2.1%)	5 (5.0%)	NS

*exclusion of patients with more than 75% missing corners per section (cervical and lumbar)

Conclusion: Lesions suggestive of axSpA in spine Xrays of patients with CBP are rare; however, even in this recent onset disease patients, squaring lesions were significantly more frequent in the recent onset axSpA patients.

Funding = ASAS grant

Ref: (1) Dougados M, et al. Joint Bone Spine. 2015; (2) van den Berg R et al. Arthritis Rheumatol. 2014

Disclosure: A. Molto, None; L. Gossec, None; V. Foltz, None; R. Beaufort, None; J. D. Laredo, None; P. Richette, None; P. Dieude, None; P. Goupille, None; A. Feydy, None; M. Dougados, Abbvie, Pfizer, Eli Lilly and Company, Novartis, UCB, Merck, Roche, BMS UCB, 2,Abbvie, Pfizer, Eli Lilly and Company, Novartis, UCB, Merck, Roche, BMS, UCB, 5.

To cite this abstract in AMA style:

Molto A, Gossec L, Foltz V, Beaufort R, Laredo JD, Richette P, Dieude P, Goupille P, Feydy A, Dougados M. X-Ray Spine Lesions Are Rare and Not Discriminant for Axial Spondyloarthritis Recognition in Patients with Recent Onset Chronic Back Pain [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/x-ray-spine-lesions-are-rare-and-not-discriminant-for-axial-spondyloarthritis-recognition-in-patients-with-recent-onset-chronic-back-pain/. Accessed .

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