Clinical characteristics of anterior chest wall pain in spondyloarthritis: An analysis of 275 patients

Elhaï, Muriel; Paternotte, Simon; Burki, Vincent; Durnez, Anne; Fabreguet, Isabelle; Koumakis, Eugénie; Meyer, Magali; Payet, Judith; Roure, Fanny; Dougados, Maxime; Gossec, Laure

doi:10.1016/j.jbspin.2011.10.003

Cited by 23 publications

(17 citation statements)

References 14 publications

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“…Arthritis of the anterior chest wall (ACW) joints in SpA involving the sternoclavicular (SCJ), the manubriosternal (MSJ), and the sternocostal joints was reported in up to 88% of SpA patients. [18][19][20] The acute inflammatory changes can be detected at an early stage by ultrasound (US) (►Fig. 4) and MRI, but the chronic structural changes that appear only when the disease progresses can also be detected by radiographs and CT, of which the latter is preferable due to its three-dimensional properties.…”

Section: Anterior Chest Wallmentioning

confidence: 99%

Imaging to Differentiate the Various Forms of Seronegative Arthritis

Eshed

Hermann

Zejden

et al. 2018

Semin Musculoskelet Radiol

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Spondyloarthritis (SpA) is a group of diseases characterized by back pain, spinal inflammation, human leukocyte antigen-B27 positivity, and peripheral findings such as dactylitis, enthesitis, and uveitis. It includes ankylosing spondylitis, psoriatic arthritis, reactive arthritis, arthritis associated with inflammatory bowel disease, and undifferentiated SpA. The role of imaging in the diagnosis, management, and follow-up of patients with SpA has become dramatically more important with the introduction of new therapies such as tumor necrosis factor-α inhibitors. Although in many instances differentiating between the SpA entities is straightforward based on the clinical presentation, often such differentiation remains challenging, and categorization of an individual patient into a subset of SpA can be difficult. Imaging, mainly radiography and magnetic resonance imaging, serves as an important diagnostic tool. Diseases in the spondyloarthritis complex share common presentation but at the same time may have distinct radiographic phenotypes. We present these common and distinct imaging manifestations that may potentially help distinguish between the entities in the diagnostic work-up.

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Section: Anterior Chest Wallmentioning

confidence: 99%

Imaging to Differentiate the Various Forms of Seronegative Arthritis

Eshed

Hermann

Zejden

et al. 2018

Semin Musculoskelet Radiol

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“…The SCJ and CCJ belonged to the ACW, suggesting that enthesis US should assess the sites of the ACW. Furthermore, several studies reported that the rate of ACW involvement was 30-50% in spondyloarthritis [25,26], and an article from the DESIR cohort revealed 44% in clinical involvement with the ACW in early spondyloarthritis [27]. Therefore, the ACW was also observed in addition to the upper and lower limbs.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Assessment of Entheses and Correlations Between Disease Activity and Ultrasound Scores in Ankylosing Spondylitis: A Cross Sectional Study

Xie¹,

Zhou²,

Luo³

et al. 2020

Preprint

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Background: An increasing number of studies have applied ultrasound (US) to evaluate enthesitis in spondyloarthritis. However, there is no clear agreement on which sites should be evaluated for enthesitis. Furthermore, there are different opinions on whether US can monitor disease activity. The objectives of this study were to evaluate the common involvement of entheses and correlations between disease activity and US scores in ankylosing spondylitis (AS).Methods: A cross-sectional, monocentric, and controlled study was performed. US was used to scan 34 entheses per person and the Madrid sonography enthesitis index (MASEI) score was used. US scores were used to evaluate the elemental lesions of hypoechogenicity, thickness, erosion, calcification, bursitis, and Doppler signal. Disease activity was assessed by Disease Activity Score–C reactive protein (ASDAS-CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).Results: 104 patients with AS and 50 control subjects were included. A total of 5236 entheses were assessed. Compared with the control subjects, only three entheses – the Achilles tendon (AT), sternoclavicular joint (SCJ), and costochondral joint (CCJ) – showed significant differences in the AS group (p < 0.05). Patients with high disease activity (ASDAS-CRP ≥ 2.1) had higher scores than patients with low activity (ASDAS-CRP < 2.1) in erosion (p = 0.02). Patients who were categorized in very high disease activity (ASDAS-CRP ≥ 3.5) had a higher score in erosion (p = 0.02). The erosion score was moderately associated with ASDAS-CRP and BASDAI (r = 0.44, r = 0.21).Conclusions: The commonly involved entheses were the AT, SCJ, and CCJ in AS. Erosion occurred more often in patients with disease activity or high activity. Erosion would be more useful for monitoring disease activity in AS.

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“…To the best of our knowledge, this is the first description of MRI findings of inflammatory ACW involvement in Korean SpA patients. The clinical involvement of the ACW has been reported in 35%∼50% of established SpA patients [3,9]. However, it also occurs in the early stage of the disease [11], and could be manifested as an initial disease symptom, ahead of inflammatory back pain.…”

Section: Discussionmentioning

confidence: 99%

Anterior Chest Wall Involvement in Spondyloarthritis Patients as Detected by Magnetic Resonance Imaging: A Case Series and Literature Review

Lee

Kim

et al. 2021

J Rheum Dis

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Magnetic resonance imaging (MRI) plays an important role in diagnosing and classifying axial spondyloarthritis (SpA) and is also useful for appropriate evaluation of disease status owing to its ability to detect inflammation early and reveal structural changes. However, dedicated MRI for the anterior chest wall (ACW) is not routinely considered despite relatively frequent presence of ACW lesions. To date, no study has investigated the imaging findings and clinical features of ACW involvement in Korean SpA patients. Thus, we aimed to show ACW involvement in SpA patients using ACW lesions found by MRI. We describe 20 cases of ACW involvement in which MRI-detected manubriosternal joint lesions. The lesion types included subchondral bone marrow edema, marginal or central bone erosions, subchondral fat infiltration or deposition, and ankylosis, with erosions being the most prevalent finding. We also provide the literature review results describing MRI findings of ACW lesions in SpA patients.

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Clinical characteristics of anterior chest wall pain in spondyloarthritis: An analysis of 275 patients

Cited by 23 publications

References 14 publications

Imaging to Differentiate the Various Forms of Seronegative Arthritis

Imaging to Differentiate the Various Forms of Seronegative Arthritis

Ultrasound Assessment of Entheses and Correlations Between Disease Activity and Ultrasound Scores in Ankylosing Spondylitis: A Cross Sectional Study

Anterior Chest Wall Involvement in Spondyloarthritis Patients as Detected by Magnetic Resonance Imaging: A Case Series and Literature Review

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