ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2457

Ankylosing Spondylitis and a Diagnostic Dilemma: Coccydynia

Rabia Deniz1, Gülsen Ozen2, Sibel Yilmaz-Oner2, Sibel Z. Aydin3, Can Erzik4, Osman Hakan Gunduz5, Nevsun Inanc6, Haner Direskeneli2 and Pamir Atagunduz6, 1Marmara University School of Medicine, Istanbul, Turkey, 2Rheumatology, Marmara University School of Medicine, Istanbul, Turkey, 3Unit of Rheumatology, Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey, 4Medical Biology, Marmara University School of Medicine, Istanbul, Turkey, 5Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey, 6Department of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Spondylarthropathies and Psoriatic Arthritis: Clinical Aspects and Treatment III

Session Type: Abstract Submissions (ACR)

Background/Purpose: Coccydynia is defined as pain in or around the tail bone area. The most common cause of coccydynia is either a trauma such as a fall directly on to the coccyx or repetitive minor trauma. The etiology remains obscure in up to 30% of patients as idiopathic. The literature on the contribution of rheumatic diseases to coccydynia is scarce. In this study, our aim was investigating the prevalence of coccydynia in Ankylosing spondylitis (AS) patients.

Methods: One hundered and seven consecutive patients with AS were evaluated for coccydynia were enrolled between January and November 2012 for a cross-sectional analysis. Seventy four consecutive patients followed for mechanical back pain as controls and the AS patients were interviewed for the presence of coccydynia. In AS patients, disease activity assessed by Bath AS disease activity index (BASDAI) and treatment with biologic agents. Collected data was evaluated on SPSS® version 11.5 and  Microsoft Excel® Programmes.

Results:

Prevalence of coccydynia in AS (38.3%) was significantly higher than the control group (p<0.0001) in both female and male AS patients (Female AS vs. control=40.9% vs. 18.4%, p=0.015 and male AS vs. control=36.5% vs. 8.0%, p=0.005). Both genders were affected equally in the AS group whereas coccydynia was slightly more frequent in female patients in the control group. In AS patients; when each individual domain of BASDAI was evaluated for the affect of coccydynia, the question about the neck, back or hip pain had significantly higher score (p:0.019) in patients with coccydynia. Overall BASDAI score was also higher in this subset of patients (p:0.020). Although not significant, the need for anti-tumour necrosis factor α (Anti-TNF α) therapy seemed also higher in patients with coccydynia, suggesting a higher disease severity (31.8 % vs. 22.2% , p=0.20).

Conclusion:

Coccydynia is a previously neglected symptom of AS and it is almost three times more common in AS than in non-specific chronic low back pain. Our observation may implicate that inflammatory diseases have a role in the etiology of coccydynia, especially in those without a history of recent or past trauma and coccydynia may be a factor associated with the severity of AS as well.

Disclosure:

R. Deniz,
None;

G. Ozen,
None;

S. Yilmaz-Oner,
None;

S. Z. Aydin,
None;

C. Erzik,
None;

O. H. Gunduz,
None;

N. Inanc,
None;

H. Direskeneli,
None;

P. Atagunduz,
None.

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