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Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

15.09. - 18.09.2021, virtuell

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Can spinous percussion in chronic back pain predict the presence of inflammatory lesions on MRI in patients with axial spondyloarthritis?

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  • Shandor Erdes - V. A. Nasonova Research Institute of Rheumatology, Laboratory of Spondyloarthritis and Psoriatic Arthritis, Moscow
  • Екатерина Агафонова - V. A. Nasonova Research Institute of Rheumatology, Laboratory of Spondyloarthritis and Psoriatic Arthritis, Moscow
  • Anastasia Dimitreva - V. A. Nasonova Research Institute of Rheumatology, Laboratory of Spondyloarthritis and Psoriatic Arthritis, Moscow
  • Maria Podrydnova - V. A. Nasonova Research Institute of Rheumatology, Laboratory of Spondyloarthritis and Psoriatic Arthritis, Moscow
  • Daria Rumiantceva - V. A. Nasonova Research Institute of Rheumatology, Laboratory of Spondyloarthritis and Psoriatic Arthritis, Moscow
  • Margarita Urumova - V. A. Nasonova Research Institute of Rheumatology, Laboratory of Spondyloarthritis and Psoriatic Arthritis, Moscow
  • Aleksander Smirnov - V. A. Nasonova Research Institute of Rheumatology, Laboratory of Spondyloarthritis and Psoriatic Arthritis, Moscow

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). sine loco [digital], 15.-18.09.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocSpA.61

doi: 10.3205/21dgrh168, urn:nbn:de:0183-21dgrh1686

Veröffentlicht: 14. September 2021

© 2021 Erdes et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

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Introduction: To analyze the possibility of using percussion of spinous processes to optimize the appointment of MRI in patients with axSpA.

Methods: The study included 131 in-patients of the Department of Spondyloarthritis of the Institute of Rheumatology for 2020, among whom AS (mNY criteria, 1984) had 89 (68%), nonradiologic SpA - 20 (15%), and psoriatic arthritis with axial lesion (psoriatic spondylitis) - 22 (17%) patients. The average age was 41.4±12.3 years, and the average duration of the disease was 13.7±9.7 years. All patients had inflammatory pain in one or more parts of the axial skeleton. In 131 patients, 215 MRI studies of the spine areas (28 cervical, 82 thoracic, 50 lumbar, and 66 sacroiliac joints /SJ/) were performed, where percussion was painful during clinical examination. MRI was analyzed by 2 doctors (a radiologist and a rheumatologist), and if there were differences of opinion, an agreed decision was made after re-evaluation. For acute inflammation (osteitis), a hyperintensive signal in the STIR was taken, and for chronic - only fat degeneration (FD), which was manifested by a hyperintensive signal in the T1. All of these changes had to be on at least 2 consecutive slices.

Results: Table 1 [Tab. 1] shows the frequency of the MRI features of acute and chronic inflammation in the vertebral bodies or SJ in patients with axSpA.

Accordingly, the sensitivity (Se) for MRI of the SJ is 86.4%, while for other parts of the spine from 40.4 to 58%.

Conclusion: Thus, in about 50% of cases, percussion of the spinous processes of the vertebrae predicts the presence of MRI-detectable injuries, and in the examination of the SJ - in 86% of cases.

Disclosures: None declared