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Osteoporosis International
Published in: Osteoporosis International 5/2015

01-05-2015 | Original Article

Bone mineral density in patients with symptoms suggestive of spondyloarthritis

Authors: M. Forien, A. Moltó, A. Etcheto, M. Dougados, C. Roux, K. Briot

Published in: Osteoporosis International | Issue 5/2015

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Abstract

Summary

Patients with axial spondyloarthritis (axSpA) have an increased risk of osteoporosis related to inflammation. We evaluate the performance of low bone mineral density (BMD) in diagnosis of axSpA for patients with symptoms suggestive of the disease. A low BMD (T ≤ −2) could be an additional tool for the diagnosis of axSpA.

Introduction

Diagnosis of axial spondyloarthritis (axSpA) can be challenging, especially in the absence of radiographic abnormalities. Patients with axSpA have an increased risk of osteoporosis related to inflammation. This study evaluated the performance of low bone mineral density (BMD) in diagnosis of axSpA for patients with symptoms suggestive of the disease.

Methods

Medical files of patients that visited a tertiary centre for symptoms suggestive of axSpA were reviewed. Two hundred and sixty-seven patients were classified in confirmed axSpA or unconfirmed axSpA according to the diagnosis of a senior rheumatologist. BMD measurements results and percentage of patients with a low BMD (T ≤ −2) at either spine or hip were compared between the two groups. Diagnostic performances of low BMD (specificity, sensitivity, positive, negative predictive values and positive likelihood ratio (LR+)) were assessed.

Results

Compared to patients with unconfirmed axSpA (n = 74), patients with confirmed axSpA (n = 193) had similar age, were more frequently male, with positive HLA B27, higher disease duration and higher C-reactive protein (CRP). Low BMD was more frequent at spine and hip, in patients with confirmed (40.3 %) than unconfirmed axSpA (24.6 %, p = 0.021). The LR+ of low BMD for an axSpA diagnosis was 2.60 and 3.12 at the spine and hip. In the subgroup of patients without any radiographic abnormalities (n = 128), the LR+ of low BMD for an axSpA diagnosis was 2.90 and 2.54 at the spine and hip.

Conclusion

In patients with symptoms suggestive of axSpA, a low BMD (T ≤ −2) could be an additional tool for the diagnosis of axSpA.
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Metadata
Title
Bone mineral density in patients with symptoms suggestive of spondyloarthritis
Authors
M. Forien
A. Moltó
A. Etcheto
M. Dougados
C. Roux
K. Briot
Publication date
01-05-2015
Publisher
Springer London
Published in
Osteoporosis International / Issue 5/2015
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-015-3044-y

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