Background Anterior chest wall (ACW) involvement is a characteristic feature of spondyloarthritis (SpA), even in early stages (1), but its paraclinic exploration is not standardized.
Objectives The aim of this study was to evaluate prevalence and type of ultrasonic (US) ACW involvement in SpA, and to look for factors associated to this involvement.
Methods This prospective monocentric study included consecutive SpA (ASAS criteria) patients and a control group (healthy subjects, discal sciatica). Clinical (pain, swelling) and US evaluation (synovitis, joint effusion, erosion, joint space narrowing, ankylosis, power Doppler activity) were performed on manubrio sternal and sterno clavicular joints. The main characteristics of SpA were recorded (disease duration, biologic features, BASDAI, ASDAS, radiographic and extra articular involvement). Patients were compared to controls (C).
Results 131 SpA and 49 control patients (same age and sex ratio) were included. Clinical and US ACW involvement was found respectively in 36 and 39% of SpA and 10 and 15% of controls (p<0.01). US findings were: synovitis (9 SpA vs 2 C), joint space narrowing (12 vs 0), erosions (34 vs 0), manubrio sternal ankylosis (24 vs 3), power Doppler activity (12 vs 2). US involvement in SpA is associated to smoking (p<0.05), history of ACW pain (p<0.05), to radiographic changes of sacro iliac joint (p=0.05), to age (45 vs 41 y, p=0.004), disease duration (14.9 vs 11.1 y, p=0.04) and presence of inflammatory bowel disease (p=0.03). US involvement is not associated to HLA-B27, enthesitis, psoriasis or uveitis, whereas clinical ACW involvement is associated with higher BASDAI (47 vs 32; p=0.0009) and ASADAS (2.9 vs 2.2; p=0.006). There is only a weak correlation between clinical and US involvement of ACW in these patients and controls.
Conclusions US involvement of ACW is frequent in SpA, associated to disease duration, smoking and bowel involvement.
Wendling D, et al. J Rheumatol 2013;40:1148-52
Disclosure of Interest None declared