Diagnosing axial spondyloarthritis by multidiciplinary team conference at 3.5 years’ follow-up in a cohort of patients with disease features according to the ASAS criteria,Scandinavian Journal of Rheumatology

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Diagnosing axial spondyloarthritis by multidiciplinary team conference at 3.5 years’ follow-up in a cohort of patients with disease features according to the ASAS criteria
Scandinavian Journal of Rheumatology ( IF 2.1 ) Pub Date : 2021-07-15 , DOI: 10.1080/03009742.2021.1933584
R M Kiil _{1,

2,

3} , C E Mistegaard _{2,

3,

4} , A G Jurik _{1,

2,

3} , A A Christiansen _{3,

5} , O Hendricks _{3,

5} , B Schiøttz-Christensen _{3,

6} , A G Loft _{2,

3,

4}

Affiliation

Objectives

During the past two decades, magnetic resonance imaging (MRI) has increasingly been used diagnostically in axial spondyloarthritis (axSpA), and in 2009 MRI was introduced in the Assessment of SpondyloArthritis Society (ASAS) classification criteria. In clinical practice, there is a risk of overdiagnosis if MRI findings are not related to clinical and biochemical findings. The aim of this study was to provide an estimate of the prevalence of axSpA in a cohort of clinical patients with low back pain and findings suggestive of axSpA according to ASAS through consensus diagnosis at a multi-disciplinary team (MDT) conference, and to describe the performance of the features included in the ASAS criteria.

Method

Consensus diagnoses of axSpA at MDT conferences were retrospectively established at 3.5 years’ follow-up in a cohort of 84 patients, initially referred with disease features according to the ASAS criteria. Patients were examined clinically regarding spondyloarthritis features, and biochemical tests and MRI of the sacroiliac joints and entire spine were performed at baseline and after a mean of 3.5 years.

Results

According to the MDT consensus, 25 patients (30%) of the total cohort had axSpA at follow-up; 40% of individuals who fulfilled the ASAS criteria at baseline had axSpA, and 37% at follow-up; 96% of axSpA patients according to the MDT consensus met the ASAS criteria at baseline and 92% at follow-up.

Conclusion

Approximately one-third of the included patients had axSpA when evaluated at the MDT conference. The ASAS criteria had low predictive value, but high sensitivity at both baseline and follow-up.

中文翻译：

根据 ASAS 标准对一组具有疾病特征的患者进行 3.5 年随访，通过多学科团队会议诊断中轴型脊柱关节炎

目标

在过去的二十年里，磁共振成像 (MRI) 越来越多地用于诊断中轴型脊柱关节炎 (axSpA)，并于 2009 年在脊柱关节炎协会评估 (ASAS) 分类标准中引入了 MRI。在临床实践中，如果 MRI 结果与临床和生化结果无关，则存在过度诊断的风险。本研究的目的是通过多学科团队 (MDT) 会议上的共识诊断，估计一组临床腰痛患者中 axSpA 的患病率，以及根据 ASAS 提示 axSpA 的发现，并描述ASAS 标准中包含的功能的性能。