Costovertebral joint involvement in radiographic axial spondyloarthritis: A case‐series computed tomography study

Abstract

Aims To evaluate structural changes of costovertebral joints (CVJ) in patients with radiographic axial spondyloarthritis (rAxSpA) using computed tomography (CT) studies. Methods Available chest or thoracic spine CT studies of 17 patients with rAxSpA and 17 patients with rheumatoid arthritis (RA) were analyzed. Ankylosis, erosions, joint space narrowing, and osteophytes were assessed. Results The groups were similar by patients' average age, but the rAxSpA group included more males (11/17) compared to the RA group (4/17, p = 0.036). In all, 748 CVJ were assessed in each patient group, including 408 head‐vertebral joints (HVJ) and 340 costotransverse joints (CTJ). rAxSpA patients had significantly more total CVJ lesions (p < 0.001 for all comparisons), more lesions in the HVJ (p < 0.001, for all comparisons), and more lesions in the CTJ (p ≤ 0.005, for all comparisons, except for osteophytes), compared to the RA group. All types of lesions, including ankylosis, erosions, narrowing, and osteophytes, were seen more frequently in rAxSpA patients. Joint space narrowing and ankylosis of the CVJ were the most frequently seen findings in rAxSpA and were distributed throughout the thoracic spine. Conclusions Structural pathology of the CVJ was more commonly observed in patients with rAxSpA than in RA patients in this study.

Costovertebral and costotransverse joint involvement in spondyloarthritis

“…However, the significantly higher CV scores in AS patients, and the CTr joint scores of the SpA group being higher than that of the RA and non‐rheumatic diseases group, may suggest that these joints are affected not only by age, but also by the inflammatory process. Research comparing CV and CTr joint alterations in AS and RA patients found that AS patients had higher structural changes, which is consistent with our findings 12 . Nevertheless, the percentage of men in the AS group was higher in both our study and the cited study.…”

“…Research comparing CV and CTr joint alterations in AS and RA patients found that AS patients had higher structural changes, which is consistent with our findings. 12 Nevertheless, the percentage of men in the AS group was higher in both our study and the cited study. Considering that men have higher joint scores, more research is required to identify whether this effect is due to gender or disease group.…”

“…There is no standard method for evaluating the involvement of these joints on CT. Involvement of the joints was classified between stages 0 and 4 according to erosion, sclerosis, and ankylosis. Another study evaluating CV and CTr joints in AS and RA patients investigated the frequency of erosion, ankylosis, narrowing, and osteophytes 12 . More comprehensive studies are required for standardization in this regard.…”

“…Another study evaluating CV and CTr joints in AS and RA patients investigated the frequency of erosion, ankylosis, narrowing, and osteophytes. 12 More comprehensive studies are required for standardization in this regard. To our knowledge, the current study is the research with the largest patient series in which CV, CTr, MS, and SC joints were examined.…”

Osseous pathologic changes in the thoracic region of the equine vertebral column: A descriptive post-mortem study in three breeds.

“…Several publications in humans report the importance, incidence and medical and surgical treatments of these joints in their relationship with back pain. [27][28][29][30][31] The high prevalence of pathology (OA, periarticular osteolysis, cyst-like lesions and fragments) of the CTJs in all breeds is of interest. Although nothing can be said yet about the possible clinical relevance of these findings, the observation certainly challenges the single focus on the APJs thus far in horses and warrants further research into these up to now overlooked joints.…”