Spinal-pelvic orientation: potential effect on the diagnosis of spondyloarthritis.

juin 24, 2019 | Posted by admin

Un nouvel article scientifique intitulé «Spinal-pelvic orientation: potential effect on the diagnosis of spondyloarthritis.» a été publié dans le journal Rheumatology (Oxford).

Carvajal Alegria G, Deloire L, Herbette M, Garrigues F, Gossec L, Simon A, Feydy A, Reijnierse M, van der Heijde D, Loeuille D, Claudepierre P, Marhadour T, Saraux A.

OBJECTIVE:

To assess associations of spinal-pelvic orientation with clinical and imaging-study findings suggesting axial SpA (axSpA) in patients with recent-onset inflammatory back pain.

METHODS:

Spinal-pelvic orientation was assessed in DESIR cohort patients with recent-onset inflammatory back pain and suspected axSpA, by using lateral lumbar-spine radiographs to categorize sacral horizontal angle (<40° vs ⩾40°), lumbosacral angle (<15° vs ⩾15°) and lumbar lordosis (LL, <50° vs ⩾50°). Associations between these angle groups and variables collected at baseline and 2 years later were assessed using the χ2 test (or Fisher’s exact) and the Mann-Whitney test. With Bonferroni’s correction, P < 0.001 indicated significant differences.

RESULTS:

Of 362 patients, 358, 356 and 357 had available sacral horizontal angle, lumbosacral angle and LL values, respectively; means were 39.3°, 14.6° and 53.0°, respectively. The prevalence of sacroiliitis on both radiographs and MRI was higher in the LL < 50° group than in the LL ⩾50° group, but the difference was not statistically significant. Clinical presentation and confidence in a diagnosis of axSpA did not differ across angle groups. No significant differences were identified for degenerative changes according to sacral horizontal angle, lumbosacral angle or LL.

CONCLUSION:

Spinal-pelvic balance was not statistically associated with the clinical or imaging-study findings suggesting axSpA in patients with recent-onset inflammatory back pain.

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

KEYWORDS:

ankylosing spondylitis; axial spondyloarthritis; lumbar lordosis; sacral slope; sacroiliitis

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