Exploring radiographic patterns of the cervical spine, including zygapophyseal joints, in axial spondyloarthritis
Introduction The assessment of the cervical spine (CS) in axial spondyloarthritis (axSpA) and its radiographic characteristics, including the zygapophyseal joints (ZJ), may be helpful for an accurate diagnosis, establishing a prognosis and enhancing treatment decisions.Objectives To describe the pre...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-02-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/10/1/e003990.full |
| _version_ | 1797222046772494336 |
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| author | Joan Miquel Nolla Diego Benavent Xavier Juanola Xabier Michelena Laura Berbel-Arcobé José Antonio Narváez |
| author_facet | Joan Miquel Nolla Diego Benavent Xavier Juanola Xabier Michelena Laura Berbel-Arcobé José Antonio Narváez |
| author_sort | Joan Miquel Nolla |
| collection | DOAJ |
| description | Introduction The assessment of the cervical spine (CS) in axial spondyloarthritis (axSpA) and its radiographic characteristics, including the zygapophyseal joints (ZJ), may be helpful for an accurate diagnosis, establishing a prognosis and enhancing treatment decisions.Objectives To describe the prevalence and characteristics of CS involvement in patients with axSpA and perform a comparison between groups according to cervical radiographic damage.Methods Patients who fulfilled the Assessment of SpondyloArthritis International Society classification criteria were included from January 2011 to January 2021. Sociodemographic, clinical, radiographic and treatment variables were gathered. Patients were categorised into ‘CS group’ (Bath Ankylosing Spondylitis Radiology Index ≥2 or De Vlam score ≥3 for ZJ) and ‘no CS group’ as controls. ZJ fusion and interobserver reliability in ZJ scoring were analysed.Results A total of 340 patients were included, 244 (71.7%) men, with mean age 57±15 years. CS involvement was observed in 181 (53.2%) patients. Patients in the CS group, as compared with no CS group, were predominantly men, older, had a higher body mass index, higher prevalence of smoking, showed higher disease activity, worse functionality and mobility, as well as more structural damage. Sixty-nine patients with CS involvement had ZJ fusion at some level. These patients showed worse mobility and more radiographic damage. Overall, ZJ involvement was observed in 99 patients (29.1%), 20 of whom did not present with vertebral body involvement.Conclusion Radiographic evaluation of CS is relevant in patients with axSpA and should be assessed routinely. Evaluation of the ZJ is particularly significant, as it is related to higher disease activity and worse function. |
| first_indexed | 2024-03-07T22:09:17Z |
| format | Article |
| id | doaj.art-83f22dac14ce42d4844dd5ba898a1503 |
| institution | Directory Open Access Journal |
| issn | 2056-5933 |
| language | English |
| last_indexed | 2024-04-24T13:15:06Z |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj.art-83f22dac14ce42d4844dd5ba898a15032024-04-04T21:50:08ZengBMJ Publishing GroupRMD Open2056-59332024-02-0110110.1136/rmdopen-2023-003990Exploring radiographic patterns of the cervical spine, including zygapophyseal joints, in axial spondyloarthritisJoan Miquel Nolla0Diego Benavent1Xavier Juanola2Xabier Michelena3Laura Berbel-Arcobé4José Antonio Narváez5Department of Rheumatology, Bellvitge University Hospital, L`Hospitalet de Llobregat, SpainDepartment of Rheumatology, Bellvitge University Hospital, L`Hospitalet de Llobregat, SpainDepartment of Rheumatology, Bellvitge University Hospital, L`Hospitalet de Llobregat, SpainDepartment of Rheumatology, Vall d`Hebron University Hospital, Barcelona, SpainDepartment of Rheumatology, Bellvitge University Hospital, L`Hospitalet de Llobregat, SpainDepartment of Radiodiagnosis, Bellvitge University Hospital, L`Hospitalet de Llobregat, SpainIntroduction The assessment of the cervical spine (CS) in axial spondyloarthritis (axSpA) and its radiographic characteristics, including the zygapophyseal joints (ZJ), may be helpful for an accurate diagnosis, establishing a prognosis and enhancing treatment decisions.Objectives To describe the prevalence and characteristics of CS involvement in patients with axSpA and perform a comparison between groups according to cervical radiographic damage.Methods Patients who fulfilled the Assessment of SpondyloArthritis International Society classification criteria were included from January 2011 to January 2021. Sociodemographic, clinical, radiographic and treatment variables were gathered. Patients were categorised into ‘CS group’ (Bath Ankylosing Spondylitis Radiology Index ≥2 or De Vlam score ≥3 for ZJ) and ‘no CS group’ as controls. ZJ fusion and interobserver reliability in ZJ scoring were analysed.Results A total of 340 patients were included, 244 (71.7%) men, with mean age 57±15 years. CS involvement was observed in 181 (53.2%) patients. Patients in the CS group, as compared with no CS group, were predominantly men, older, had a higher body mass index, higher prevalence of smoking, showed higher disease activity, worse functionality and mobility, as well as more structural damage. Sixty-nine patients with CS involvement had ZJ fusion at some level. These patients showed worse mobility and more radiographic damage. Overall, ZJ involvement was observed in 99 patients (29.1%), 20 of whom did not present with vertebral body involvement.Conclusion Radiographic evaluation of CS is relevant in patients with axSpA and should be assessed routinely. Evaluation of the ZJ is particularly significant, as it is related to higher disease activity and worse function.https://rmdopen.bmj.com/content/10/1/e003990.full |
| spellingShingle | Joan Miquel Nolla Diego Benavent Xavier Juanola Xabier Michelena Laura Berbel-Arcobé José Antonio Narváez Exploring radiographic patterns of the cervical spine, including zygapophyseal joints, in axial spondyloarthritis RMD Open |
| title | Exploring radiographic patterns of the cervical spine, including zygapophyseal joints, in axial spondyloarthritis |
| title_full | Exploring radiographic patterns of the cervical spine, including zygapophyseal joints, in axial spondyloarthritis |
| title_fullStr | Exploring radiographic patterns of the cervical spine, including zygapophyseal joints, in axial spondyloarthritis |
| title_full_unstemmed | Exploring radiographic patterns of the cervical spine, including zygapophyseal joints, in axial spondyloarthritis |
| title_short | Exploring radiographic patterns of the cervical spine, including zygapophyseal joints, in axial spondyloarthritis |
| title_sort | exploring radiographic patterns of the cervical spine including zygapophyseal joints in axial spondyloarthritis |
| url | https://rmdopen.bmj.com/content/10/1/e003990.full |
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