Prevalence of Inflammatory Backache and Radiographic Axial Spondyloarthritis Among Patients with Musculoskeletal Backache in Outdoor Patients of Rheumatology Department at PIMS Hospital

Gulelala; Uzma Rasheed; Shazia Zammurrad; Taha Mohammad Usman Pasha; Muhammad Sufyan Khan; Sadia Mansoor

doi:10.51253/pafmj.v76iSUPPL-2.11338

Authors

Gulelala Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad Pakistan
Uzma Rasheed Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad Pakistan
Shazia Zammurrad Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad Pakistan
Taha Mohammad Usman Pasha Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad Pakistan
Muhammad Sufyan Khan Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad Pakistan
Sadia Mansoor Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-2.11338

Keywords:

Inflammatory backache, Musculoskeletal Backache, Radiographic Axial Spondyloarthritis, Sacroiliitis.

Abstract

Objective: To assess inflammatory back ache and radiographic axial spondylarthritis among patients with musculoskeletal backache in a single-center sample from Pakistan.

Study Design: Analytical cross-sectional study.

Place and Duration of Study: Department of Rheumatology, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan, from Apr to Sep 2023.

Methodology: Patients visiting the Rheumatology outpatient department (OPD), with backache, were assessed for inflammatory backache using the Assessment of Spondyloarthritis International Society (ASAS) criteria to determine the occurrence of spondyloarthritis. Pain levels were recorded on a Visual Analogue Scale (VAS) and sacroiliitis on imaging was also recorded as per the modified New York criteria.

Results: Out of a sample of 74 patients, 48(64.90%) were diagnosed as having inflammatory backache. Patients with inflammatory backache had higher pain levels (median = 6.00, IQR = 1.00 VAS) and more frequently reported higher C-reactive protein (CRP) levels (n=12, 92.30%) and greater pain levels, as compared to those without inflammatory backache (median = 5.00, IQR = 2.00 VAS; higher CRP n = 1, 7.70%).

Conclusion: Inflammatory backache was highly frequent among patients with backache and associated clinical features were more frequently present among patients with inflammatory backache.

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References

1. El-Tallawy SN, Nalamasu R, Salem GI, LeQuang JAK, Pergolizzi JV, Christo PJ et al. Management of musculoskeletal pain: an update with emphasis on chronic musculoskeletal pain. Pain Ther 2021; 10(1): 181–209.

https://doi.org/10.1007/s40122-021-00235-2

2. Lassiter G, Melancon C, Rooney T, Murat AM, Kaye JS, Kaye AM, et al. Ozanimod to treat relapsing forms of multiple sclerosis: a comprehensive review of disease, drug efficacy and side effects. Neurol Int 2020; 12(3): 89–108.

https://doi.org/10.3390/neurolint12030016

3. Poddubnyy D, Callhoff J, Spiller I, Listing J, Braun J, Sieper J, et al. Diagnostic accuracy of inflammatory back pain for axial spondyloarthritis in rheumatological care. RMD Open 2018; 4(2): e000825. https://doi.org/10.1136/rmdopen-2018-000825

4. Rasool T, Umer TP, Nazir L, Arain SR, Phulpoto K, Afzal W et al. Axial spondyloarthritis in patients with chronic backache using assessment of spondyloarthritis international society criteria for axial spondyloarthritis. J Ayub Med Coll Abbottabad 2018; 30(2): 253–257.

5. Ramiro S, Nikiphorou E, Sepriano A, Ortolan A, Webers C, Baraliakos X, et al. Response to: correspondence on "ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update" by Braun et al. Ann Rheum Dis 2023; 82(9): e206.

https://doi.org/10.1136/ard-2023-223937

6. Robinson PC, Sengupta R, Siebert S. Non-radiographic axial spondyloarthritis (nr-axSpA): advances in classification, imaging and therapy. Rheumatol Ther 2019; 6(2): 165–177.

https://doi.org/10.1007/s40744-019-0146-6

7. Reveille JD, Weisman MH. The epidemiology of back pain, axial spondyloarthritis and HLA-B27 in the United States. Am J Med Sci 2013; 345(6): 431–436.

https://doi.org/10.1097/MAJ.0b013e318294457f

8. Hamilton L, Macgregor A, Warmington V, Pinch E, Gaffney K. The prevalence of inflammatory back pain in a UK primary care population. Rheumatology 2014; 53(1): 161–164.

https://doi.org/10.1093/rheumatology/ket344

9. Tong F, Lv Q, Li A, Fang L, Luo Z, Feng J, et al. An epidemiological study of the prevalence rate of inflammatory back pain and axial spondyloarthritis in a university in the south of China. Clin Rheumatol 2018; 37(11): 3087–3091.

https://doi.org/10.1007/s10067-018-4175-2

10. Saeed MA, Ahmed H, Faiq M, Aslam Z, Khan SEA, Batool S, et al. Prevalence of inflammatory back pain and radiographic axial spondyloarthritis in a semi-urban community of Lahore, Pakistan. Int J Rheum Dis 2021; 24(2): 207–215.

https://doi.org/10.1111/1756-185X.14030

11. Rudwaleit M, Van der Heijde D, Landewé R, Akkoc N, Brandt J, Chou CT, et al. The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis 2011; 70(1): 25–31.

https://doi.org/10.1136/ard.2010.133645

12. Sieper J, Rudwaleit M, Baraliakos X, Brandt J, Braun J, Burgos-Vargas R, et al. The Assessment of SpondyloArthritis International Society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis 2009; 68(Suppl 2):1–44.

13. Van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 1984; 27(4): 361–368. https://doi.org/10.1002/art.1780270401

14. Oliveira J, Nunes R, Da Silva G, Nogueira I, Azevedo A, Baraliakos X, et al. Prevalence of inflammatory back pain in a low-income population. J Clin Rheumatol 2022; 28(3): 170–173.

https://doi.org/10.1097/RHU.0000000000001829

15. Kishimoto M, Yoshida K, Ichikawa N, Inoue H, Kaneko Y, Kawasaki T, et al. Clinical characteristics of patients with spondyloarthritis in Japan in comparison with other regions of the world. J Rheumatol 2019; 46(8): 896–903.

https://doi.org/10.3899/jrheum.180412

16. Strand V, Singh JA. Evaluation and management of the patient with suspected inflammatory spine disease. Mayo Clin Proc 2017; 92(4): 555–564.

https://doi.org/10.1016/j.mayocp.2016.12.008

17. Jovaní V, Blasco-Blasco M, Ruiz-Cantero MT, Pascual E. Understanding how the diagnostic delay of spondyloarthritis differs between women and men: a systematic review and metaanalysis. J Rheumatol 2017; 44(2): 174–183.

https://doi.org/10.3899/jrheum.160825

18. Redeker I, Callhoff J, Hoffmann F, Haibel H, Sieper J, Zink A, et al. Determinants of diagnostic delay in axial spondyloarthritis: an analysis based on linked claims and patient-reported survey data. Rheumatology 2019; 58(9): 1634–1638.

https://doi.org/10.1093/rheumatology/kez090