早期SpA患者髋关节的受累发生率

早期SpA患者髋关节的受累发生率

PresentID:FRI

原文

HOWOFTENAREHIPJOINTSINVOLVEDINPATIENTSWITHEARLYSPONDYLOARTHRITIS?

T.Dubinina1,*,E.Gubar1,A.Demina1,O.Rumyantseva1,S.Shubin1,S.Krasnenko1,R.Balabanova1,M.Urumova1,S.Erdes1

1VANASONOVARESEARCHINSTITUTEOFRHEUMATOLOGY,RUSSIA,MOSCOW,Moscow,RussianFederation

Background:Previousstudiesshowedthatpatientswithcoxitishavehigherdiseaseactivityandmorepronouncedfunctionalimpairments.Followingthesefindingsearlydetectionofcoxitisisofgreatclinicalimportance.

Objectives:TostudytheincidenceofHJinvolvementinpatientswithearlyspondyloarthritis(SpA).

Methods:Thestudyincludedpatients(meanage28,7±7,5y):77(59,2%)withaxialSpA(axSpA,ASAS)and53(40,8%)withperipheralSpA(pSpA,ASAS),56,9%–females,83,7%-HLAB27-positive.AveragediseasedurationinaxSpAwas19,7±14,8mo,inpSpA–8,9±8,8mo.Thefollowingevaluationsweremade:BASDAI,ASDAS-CRP,ASDAS-ESR,BASFI,HJpain(numericalratingscale–NRS-from0to10),inter-malleolardistance(IMD),radiologicalHJchanges(BASRIhip),ultrasoundexamination(US)andMRIofhipjoints.

Results:74(56,9%)outofpatientssufferedpaininHJ(themajorityofthem(73%)metaxialSpAcriteria).67,6%outof74patientshadpainintherightHJ,85,1%-intheleftHJ,while52,7%-hadpaininbothHJ.MeanpainscoreintherightHJwas5,5±7,8,intheleftHJ–4,6±6,0.MeandurationofHJpainwas9,1±10,9mo.HJfuncionallimitationsweredocumentedin27patients(36,5%),bilateralwerefoundin66,7%.IMDwas90,4±15,5cm.Functionallimitationslastedfor8,7±9,4moinaverage.HJradiologicalchangesweredocumentedin20(27,0%)outof74patients:in9cases-BASRIhip=2,in11cases–BASRIhip=1.USsymptomsofcoxitis(thedistancebetweentheanteriorjointcapsuleandthefemoralneck,capsular-neckdistanceCND7mm)werefoundin32joints(ontheright–14(CND8,4±5,9mm),ontheleft–18(8,3±1,5mm)).InflammatoryMRIsymptomswerefoundin41joints(ontheright–20(swellingofbonemarrowinfemoralhead–3,swellingofacetabularroof–5,synovitis–20),ontheleft–21(swellingofbonemarrowinfemoralhead–6,swellingofacetabularroof–7,synovitis–21).PatientswithearlySpAandHJinvolvementhadhigherdiseaseactivityvspatientswithoutHJinvolvement(BASDAI(4,3±2,1vs3,2±1,8),ASDAS-CRP(2,8±1,3vs1,8±1,2),ASDAS-ESR(2,7±1,4vs1,9±1,4)),althoughwithoutanydifferenceinfunctionalimpairmentbyBASFI.

Conclusions:1.HJinvolvementismore







































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