Zánětlivá bolest v zádech – význam při screeningu a diagnostice spondyloartritid


Authors: K. Pavelka;  H. Mann
Authors‘ workplace: Revmatologický ústav Praha, Revmatologická klinika 1. LF UK
Published in: Čes. Revmatol., 22, 2014, No. 3, p. 143-152.
Category: Review Article

Overview

The concept of classification and diagnosis of axial spondyloarthritis (ax SpA) has been developed in the last 10 years. Axial SpA is basically divided into ankylosing spondylitis (satisfying the so called New York criteria with radiographic sacroiliitis) and so called non-radiographic axial spondyloarthritis, which meets the ASAS criteria. These criteria focus mainly on the new and later again modified criteria for inflammatory back pain (IBP). The first part of the paper presents significant epidemiological studies that evaluate the utilization of individual criteria for inflammatory back pain.

The second part of the article discusses different strategies of referring the patients with suspected axial SpA from general practitioners and orthopedic surgeons to specialists (rheumatologists). A simple scheme working with three parameters (inflammatory back pain, HLA B27 antigen positivity, and suspected sacroiliitis on imaging techniques) is equally efficient as more complicated strategies. Positivity of two criteria enables a correct diagnosis of axial SpA in 30-50% of patients. Recently, a so called two-step strategy has been proposed that reduces the number of patients, in whom the determination of HLA-B27 needs to be performed, in half. Novel screening questionnaires, which are filled out by patients, are discussed herein as well.

Key words:
ankylosing spondylitis , diagnostics, axial spondyloarthritis


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Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
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