ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1504

More Than 10 Percent Patients with Recent Onset Chronic Mechanical Back Pain Fulfill the Modified NY Criteria for Sacroiliitis

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, 7Department of Rheumatology, CHRU de Tours; and Université François-Rabelais de Tours, 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: MRI, performance and spondylarthritis

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Monday, November 6, 2017

Session Title: Spondyloarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment Poster II

Session Type: ACR Poster Session B

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

Background/Purpose: only scarce data are available regarding the diagnostic value of pelvic Xrays abnormalities suggestive of axial spondyloarthritis (axSpA) in patients with recent onset back pain to distinguish mechanical chronic back pain (CBP) and axSpA.

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

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) 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) 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: Pelvic 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: prevalence of lesions suggestive of axSpA and the fulfilment of the mNY criteria for radiographic sacroiliitis were compared in both groups. Sensitivity, specificity and positive likelihood ratio of each lesion for the diagnosis of axSpA were calculated.

Results:

A total of 98 patients with CBP were included, and compared to 100 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).

Patients with axSpA had consistently more lesions suggestive of axSpA than CBP patients (Table), and presence of erosions showed the best positive likelihood ratio. The fulfilment of mNY criteria presented also a high positive likelihood ratio (LR+).

LESIONS

CBP n=98

axSpA n=100

p

Sensitivity

Specificity

LR+

  • Erosion

9/97 (9.3%)

35 (35.0 %)

<0.001

0.4 (0.3, 0.5)

0.9 (0.8, 0.9)

3.8 (1.9, 7.4)

  • Sclerosis

21/97 (21.6%)

50 (50.0%)

<0.001

0.5 (0.4, 0.6)

0.8 (0.7, 0.9)

2.3 (1.5, 3.5)

  • Joint widening

13/97 (13.4%)

25 (25.0%)

0.06

0.3 (0.2, 0.4)

0.9 (0.8, 0.9)

1.9 (1.0, 3.4)

  • Joint narrowing

11/97 (11.3%)

21 (21.0%)

NS

0.2 (0.1, 0.3)

0.9 (0.8, 0.9)

1.9 (0.9, 3.6)

  • Partial ankylosis

7/97 (7.2%)

11 (11.0%)

NS

0.1 (0.1, 0.2)

0.9 (0.9, 0.9)

1.5 (0.6, 3.8)

  • Total ankylosis

0

3 (3.0%)

NS

0.0 (0.0, 0.1)

1.0 (0.9, 1.0)

NA*

Modified NY criteria (Y/N)

11/95 (11.6%)

35 (35.0%)

<0.001

0.4 (0.3,0.5)

0.9 (0.8,0.9)

3.0 (1.6, 5.6)

* NA = not applicable, since one of the categories is 0, Specificity can not be calculated.

Conclusion:

Prevalence of sacroiliac lesions suggestive of axSpA in pelvic Xrays of patients with recent onset CBP is high, but significantly lower when compared to recent onset axSpA. Presence of erosions and fulfilment of mNY criteria were the best performing features for axSpA recognition even in an early disease stage.

Ref: (1) Dougados M, et al. cohort. 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. More Than 10 Percent Patients with Recent Onset Chronic Mechanical Back Pain Fulfill the Modified NY Criteria for Sacroiliitis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/more-than-10-percent-patients-with-recent-onset-chronic-mechanical-back-pain-fulfill-the-modified-ny-criteria-for-sacroiliitis/. Accessed January 26, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/more-than-10-percent-patients-with-recent-onset-chronic-mechanical-back-pain-fulfill-the-modified-ny-criteria-for-sacroiliitis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.