SPONDİLOARTRİT TANILI HASTALARDA KOSTOVERTEBRAL, KOSTOTRANSVERS, STERNOKLAVİKULAR VE MANİBRİOSTERNAL EKLEM TUTULUMUNUN İNCELENMESİ

Abstract

Ata EB, Investigation of Costovertebral, Costotransverse, Sternoclavicular and Manibriosternal Joint Involvement in Patients Diagnosed with Spondyloarthritis, Hacettepe University Department of Internal Medicine, Thesis in Internal Medicine, Ankara, 2022. The aim of this study is to examine the overlooked involvement of costovertebral (CV), costotransverse (CT), sternoclavicular (SK) and manibriosternal (MS) joints in patients with a diagnosis of spondyloarthritis (SpA) and their relationship with clinical, radiological and laboratory findings. In the study, 341 subjects over the age of 18 years old who were admitted to our rheumatology clinic between January 1, 2010 and December 31, 2020 and who had a thorax computed tomography (CT) scan for any reason was included. Of these subjects, 281 had a diagnosis of SpA and no other concomitant rheumatological diagnosis, 30 patients had a diagnosis of rheumatoid arthritis and 30 were healthy controls. Retrospectively collected data were evaluated with appropriate statistical methods. Of the SpA patients, 206 (73.3%) were diagnosed with AS, 63 (22.4%) with psoriatic arthritis (PsA), and 12 (4.3%) with nonradiographic axial SpA (nr-AksSpA). 34 (54%) of PsA patients had axial PsA. Total scores of CV joint were different between diseases (AS 35, PsA 16, axial PsA 16, peripheral PsA 20, nr-AksSpA 6.5, RA 15.5, healthy control 13 (p<0.001)). Similarly, total scores of CT joint were different between diseases (AS 16, PsA 13, axial PsA 12, peripheral PsA 14, nr-AksSpA 14, RA 6.5, healthy control 4 (p<0.001)). In SpA patients, all joint scores were significantly higher in the group with syndesmophyte (66.5 vs. 14.5 for CV, 29.5 vs. 10 for KT, 4 vs. 1.5 for SC, 3 vs. 2 for MS (p< 0.001 for each joint)). CV and CT joint involvement was higher in the smoking group (21 vs. 33 for CV (p=0.013), 12 vs. 16 for CT (p=0.008)). In AS patients, a strong negative correlation was found between chest expansion and joint involvement with CV (r=- 0.709, p<0.001) and CT (r=-0.689, p<0.001) joints. In light of these results, it may be beneficial to evaluate these joints, which have the potential to be overlooked clinically, and to initiate patients with CT and CV joint involvement in exercise programs in the early period.