Abstract:
BACKGROUND:Early detection of patients with axial spondylarthritis (axSpA) in primary care is difficult. The combination of various parameters indicative of inflammatory back pain (AWARE criteria) was found to be beneficial in an initial study. OBJECTIVE:Review of the criteria for the identification of young patients with axSpA and chronic back pain (≥3 months of back pain). MATERIAL AND METHODS:In adult patients with chronic back pain and age at onset of symptoms <45 years, orthopedic surgeons documented various possible axSpA characteristics before referral to the rheumatologist. RESULTS:Overall, the data from 1306 patients were recorded. Of these, ultimately 500 patients were also seen by rheumatologists, 199 patients (39.8%) were diagnosed with axSpA while 301 (60.2%) had non-specific back pain. A total of 87 patients had ankylosing spondylitis (44%) and 112 non-radiographic axSpA (56%). The ASAS classification criteria were fulfilled by 226 patients (45.2%). The mean age of axSpA patients was 38 years, 56% were male with a mean duration of back pain of 98 months. The AWARE criteria had a sensitivity and specificity of 69.3% and 40.3% (n = 343), respectively, when ≥4/5 criteria were chosen. Positive imaging for sacroiliitis using magnetic resonance imaging (MRI) or X‑ray was present in 77% of patients and positive HLA-B27 was identified in 59% of axSpA patients. The combination of positive imaging and HLA-B27 had the highest likelihood ratio for diagnosis of axSpA. CONCLUSION:Although the study design used here led to a preselection and thus to a bias in the statistical evaluation, the study confirmed the benefit of the AWARE criteria for the early detection of patients with axSpA. In further studies, the 2‑stage approach with initially 3 clinical questions and then an optional HLA-B27 test is currently being investigated further.
journal_name
Z Rheumatoljournal_title
Zeitschrift fur Rheumatologieauthors
Braun J,Mosch T,Fischer I,Kiltz Udoi
10.1007/s00393-018-0550-2subject
Has Abstractpub_date
2019-08-01 00:00:00pages
568-576issue
6eissn
0340-1855issn
1435-1250pii
10.1007/s00393-018-0550-2journal_volume
78pub_type
杂志文章,评审abstract::In recent years, new findings in immunology have been successfully converted to therapeutic principles, in particular for rheumatoid arthritis (RA) and spondylarthritides. The introduction of cytokine blockers in RA using tumor necrosis factor (TNF)-alpha and interleukin (IL)-1 inhibitors presented the first original ...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
doi:10.1007/s00393-009-0436-4
更新日期:2009-07-01 00:00:00
abstract::Fractalkine (CX3CL1), so far the only member of the CX3C class of chemokines, and its receptor, CX3CR1, are strongly expressed in the chronically inflamed synovial tissue of patients with rheumatoid arthritis (RA). Due to the specific binding of Fractalkine to its receptor, many proinflammatory reactions involved in t...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:10.1007/s00393-008-0326-1
更新日期:2008-09-01 00:00:00
abstract::The diagnosis of rheumatoid arthritis has been hampered by the lack of a truly disease-specific serologic marker. Thus, despite its moderate specificity rheumatoid factor (RF) is still the only established marker antibody for RA and among the diagnostic criteria of the American College of Rheumatology the only serolog...
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更新日期:2002-12-01 00:00:00
abstract::D-penicillamine treatment of 50 patients with rheumatoid arthritis with negative ANF tests, was followed by means of protein disk electrophoresis of the urine. In the beginning the urine proteins were analysed every 4 weeks, later at intervals of 3 to 6 months. A glomerular proteinuria, caused by an immune-complex nep...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
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abstract::MicroRNAs are small non-coding RNAs which are crucial for the fine regulation of gene expression. Recent results suggest that these molecules display multifaceted functions in B-cells and T-cells in rheumatic inflammatory diseases. ...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
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更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Rheumatoid arthritis is found in approximately 2 % of the total population in Europe and the peak incidence of the disease is during the fourth and fifth decades of life. In approximately 15 % the first symptoms of the disease occur at the level of the foot and ankle. If the early stage-dependent therapy wit...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
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journal_title:Zeitschrift fur Rheumatologie
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
更新日期:1995-07-01 00:00:00
abstract::Magnetic resonance imaging (MRI) is a mainstay in musculoskeletal imaging. The term"bone marrow edema" is frequently used for describing the radiological findings, especially with respect to rheumatic diseases. The referring physician should be aware that this term has a purely descriptive character and the pathophysi...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
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更新日期:2012-01-01 00:00:00
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 传,历史文章,杂志文章
doi:10.1007/s00393-009-0541-4
更新日期:2009-12-01 00:00:00
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章,评审
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journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
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abstract:BACKGROUND:Psoriatic onycho-pachydermo-periostitis is a rare manifestation of psoriatic arthritis. It is characterized by the trias of psoriatic onychosis, tender soft tissue thickening, and osteoperiostitis of the distal phalanges in the absence of distal interphalangeal arthritis. Recommendations for the treatment of...
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更新日期:1987-01-01 00:00:00
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更新日期:2011-04-01 00:00:00
abstract::Three days after cholecystectomy, seven patients received a single dose of auranofin (5 tablets Ridaura = 4.35 mg gold). At defined time points thereafter the gold content in samples of blood, plasma, urine, bile, and feces was determined by instrumental neutron activation analysis (INAA). Maxima of the mean gold conc...
journal_title:Zeitschrift fur Rheumatologie
pub_type: 杂志文章
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更新日期:1991-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2005-06-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2017-12-01 00:00:00
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pub_type: 杂志文章,实务指引,评审
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更新日期:2020-09-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2013-11-01 00:00:00