Медицина в Кузбассе (Oct 2019)
THE PREVALENCE OF CLINICAL SYMPTOMS IN PATIENTS ANKYLOSING SPONDYLOARTHRITIS IN THE RHEUMATOLOGY DEPARTMENT
Abstract
Goal – the purpose of the study is to analyze the prevalence of the clinical significant symptoms of ankylosing spondyloarthritis (AS). Material and methods. The study included 70 patients with AS treated in the rheumatology department of the ССН №1 in Novokuznetsk for three years. In the diagnosis of the AS used modified New York 1984 criteria. All patients underwent an X-ray examination of the spine and sacroiliac joints, and some patients received multispiral computed tomography and magnetic resonance imaging. Results. Of the 70 patients, there were 55 (78.5 %) men, 15 (21.5 %) women. The average age was 41.2 ± 9.8 years. The average duration from the beginning of the first symptoms to diagnosis is 11.4 ± 8.6 years. Inflammatory spinal pain was present in 52 (74.3 %) patients. Asymptomatic course of sacroiliitis in the presence of radiographic signs was detected in 47 (67.2 %) patients. Of the lesions of the joints, arthritis of the hip joints prevailed in 35 (50 %) patients. Of the extra-articular lesions, unilateral uveitis was registered in 14 (20 %) patients, less often bilateral – in 2 (2.8 %) patients. Evaluation of X-ray studies showed that the most frequent were: ossification of the anterior longitudinal ligament in 32 (45.7 %) patients, syndesmofites in the lumbar, thoracic, cervical spine in 19 (27.1 %) patients; the symptom of the «bamboo stick» in 22 (31.4 %), kyphosis of the cervical spine in 7 (10 %) patients, bilateral sacroiliitis was diagnosed in 100 % of patients. Degenerative-dystrophic changes in the spine were diagnosed in the cervical region in 8 (11.4 %), in the thoracic in 5 (7.1 %), in the lumbar region in 8 (11.4 %), disc protrusion in 9 (12.8 %), herniated disc in 7 (10 %) patients. Findings. Attention is drawn to the long period of diagnosis of the AS – 11.4 ± 8.6 years. Of the articular lesions, the hip joints prevail in 50 % of patients. In 47 % of patients there was an asymptomatic course of sacroiliitis in the presence of radiological signs. Radiographic signs of the AS at different levels of the spine were recorded in less than half of the patients — from 27.1 % to 45.7 %.
