Zánětlivá bolest v zádech – význam při screeningu a diagnostice spondyloartritid
Authors:
K. Pavelka; H. Mann
Authors place of work:
Revmatologický ústav Praha, Revmatologická klinika 1. LF UK
Published in the journal:
Čes. Revmatol., 22, 2014, No. 3, p. 143-152.
Category:
Review Article
Summary
The concept of classification and diagnosis of axial spondyloarthritis (ax SpA) has been developed in the last 10 years. Axial SpA is basically divided into ankylosing spondylitis (satisfying the so called New York criteria with radiographic sacroiliitis) and so called non-radiographic axial spondyloarthritis, which meets the ASAS criteria. These criteria focus mainly on the new and later again modified criteria for inflammatory back pain (IBP). The first part of the paper presents significant epidemiological studies that evaluate the utilization of individual criteria for inflammatory back pain.
The second part of the article discusses different strategies of referring the patients with suspected axial SpA from general practitioners and orthopedic surgeons to specialists (rheumatologists). A simple scheme working with three parameters (inflammatory back pain, HLA B27 antigen positivity, and suspected sacroiliitis on imaging techniques) is equally efficient as more complicated strategies. Positivity of two criteria enables a correct diagnosis of axial SpA in 30-50% of patients. Recently, a so called two-step strategy has been proposed that reduces the number of patients, in whom the determination of HLA-B27 needs to be performed, in half. Novel screening questionnaires, which are filled out by patients, are discussed herein as well.
Key words:
ankylosing spondylitis , diagnostics, axial spondyloarthritis
Zdroje
1. Rudwaleit M. New classification criteria for spondyloarthritis. Int J Adv Rheumatol 2010; 8 (1): 1–7.
2. Rudwaleit M, van der Heide D, Landewe R, et al. The development of ASAS criteria for axial spondyloarthritis “(part II)“ validation and final selection. Ann Rheum Dis 2009; 68: 777–83.
3. Calin A, Porta J, Fries JF, et al. Clinical history as a screening test for ankylosing spondylitis. JAMA 1977; 237 (24): 2613–4.
4. Rudwaleit M, Mettner A, Listing J, et al. Inflammatory back pain in ankylosing spondylitis „a reassessment of the clinical history for application as classification and diagnostic criteria. Arthritis Rheum 2006; 54 (2): 569–78.
5. Sieper J, van der Heide D, Landewe R, et al. New criteria for inflammatory back pain in patients with chronic back pain a real patient exercise by experts from the ASAS. Ann Rheum Dis 2009; 68 (6): 784–8.
6. Weisman MH, Witter J, Reveile JD. The prevalence of inflammatory back pain population – based estimates from the US National Health and Nutrition Examination Survey, 2009-10. Ann Rheum Dis 2013; 72(3): 369–373.
7. Rojas Vargas M, Munoz-Gomariz E, Escudero A. First signs and symptoms of spondyloarthritis – data from an inception cohort with a disease course of two years or less. Rheumatology (Oxford) 2009; 48(4): 535–43.
8. van der Berg R, Hooge M, Gaalen F, et al. Percentage of patients with spondyloarthritis in patients referred because of chronic back pain and performance of classification criteria experience from the Spondylo-Arthritis Caught Early (SPACE)-cohort. Rheumatology (Oxford) 2013; 52(8): 1492–9.
9. Braun J, Inman R. Clinical significance of inflammatory back pain for diagnosis and screening of patients with axial spondyloarthritis. Ann Rheum Dis 2010; 69 (7): 1264–8.
10. Van der Berg, Hooge M, Rudwaleit M, et al. ASAS modification of the Berlin algorithm for diagnosing axial spondyloarthritis results from the SPACE and ASAS cohorts. Ann Rheum Dis 2013; 72(10): 1646–53.
11. Rudwaleit M, Khan M, Sieper J. The challenge of diagnosis and classification in early ankylosing spondylitis do we need new criteria? Arthritis Rheum 2005; 52 (4): 1000 –8.
12. Sieper J, Rudwaleit M. Early referral recommendations for ankylosing spondylitis in primary care. Ann Rheum Dis 2005; 64(5): 659–63.
13. Hermann J. Early spondyloarthritis: usefulness of clinical screening. Rheumatol 2009; 48 (7): 812–6.
14. Braun J. Identifying patients with axial spondyloarthritis in primary care: how useful are items indicative of inflammatory back pain? Ann Rheum Dis 2011; 70 (10): 1782–7.
15. Brandt HC, et al. Performance of referral recommendations in patients with chronic back pain and suspected axial spondyloarthritis. Ann Rheum Dis 2007; 66 (1): 1479–84.
16. Poddubnyy D, et al. Evaluation of 2 screening strategies for early identification of patients with axial spondyloarthritis in primary care. J Rheumatol 2011; 38 (11): 2452–60.
17. Sieper J, Srinivasan S, Zamani O, et al. Comparison of two referral strategies for diagnosis of axial SpA. The recognizing and diagnosing ankylosing spondylitis reliably (RADAR). Ann Rheum Dis 2013; 72 (10): 1621–7.
18. Braun J, Gnann H, Saracbasi E, et al. Optimizing the identification of patients with axial spondyloarthritis in primary care- the case for a two step strategy combining the most relevant clinical items with HLA B 27. Rheumatology 2013; 52 (8): 1418–24.
19. Keeling S, Majumdar S, Conner-Spady B, et al. Preliminary validation of self –reported screening questionnaire for inflammatory back pain. J Rheumatol 2012; 39(4): 822–9.
20. Hamilton L, Macgregor A, Newman D, et al. Validation of patient self-reported screening questionnaire for axial spondyloarthropathy in UK population. Spine 2013; 38 (6): 502–6.
21. Alnaqbi KA, Touma Z, Passelent L, et al. Development, sensibility and reliability of the Toronto Axial Spondyloarthritis Questionnaire in Inflammatory Bowel Disease. J Rheumatol 2013; 40(10): 1726 – 36.
Štítky
Dermatology & STDs Paediatric rheumatology RheumatologyČlánok vyšiel v časopise
Czech Rheumatology
2014 Číslo 3
Najčítanejšie v tomto čísle
- Zánětlivá bolest v zádech – význam při screeningu a diagnostice spondyloartritid
- The role of new pro-inflammatory and/or pro-fibrotic molecules in the pathogenesis of systemic sclerosis