Background/Purpose: Hidradenitis suppurativa (HS) has been associated with inflammatory joint diseases such as psoriatic arthritis and ankylosing spondylitis.  Despite this correlation, dermatologists do not routinely inquire about inflammatory arthritic symptoms in HS patients. In this clinic-based quality improvement project, we aimed to comprehensively capture the musculoskeletal (MSK) symptom burden in a cohort of patients with HS using the IDEOM Musculoskeletal Questionnaire (MSK-Q), a 9-item instrument which measures the severity of MSK symptoms and impact on patient quality of life.

Methods: This study included a convenience sample of clinic patients who presented with HS and completed the IDEOM MSK-Q. The IDEOM MSK-Q is divided into three subscores: the first subscore contains three questions about MSK symptom severity, the next subscore includes five questions to assess MSK symptom impact, and the last subscore contains one question about fatigue. Demographic and clinical data were extracted from the electronic medical record, and statistical analysis was performed.

Results: Over a 12-month period, 73 patients with HS completed the IDEOM MSK-Q. The mean age was 35.3±13.1. Fifty-four (74.0%) reported some degree of joint pain, swelling, or stiffness over the past seven days. Of the 54, 22 (40.7%) had comorbid musculoskeletal disorders, most commonly osteoarthritis (n=5). MSK symptoms had the greatest impact on daily physical activities (mean impact rating of 5.1±3.6/10) compared to other categories in the symptom impact subscore. Notably, Spearman’s rank-order correlation analysis demonstrated a statistically significant positive relationship between the reported impact of MSK symptoms on work or school activities from 0-10 (Question 4 of the IDEOM MSK-Q) and Hurley stage. This indicates that as Hurley stage increases, the impact of MSK symptoms on work or school activities also tends to increase (ρ = 0.32, p = 0.032). Furthermore, the majority of all participants (70.4%) ranked fatigue ≥7/10 over the past week, a symptom commonly associated with active disease in inflammatory arthritis. The mean fatigue rating was 7.4±2.4/10.

Conclusion: Our exploratory analysis indicates a substantial burden of MSK symptoms among patients with HS. The IDEOM MSK-Q may serve as a useful tool for measuring MSK symptoms and their impact, warranting further development and validation of this instrument for the HS population.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessing-musculoskeletal-symptom-burden-in-a-cohort-of-patients-with-hidradenitis-suppurativa-using-the-ideom-msk-q/