Document Detail


Computerized tomography scan facilitates the diagnosis of sacroiliitis in patients with suspected spondyloarthritis: Results of the ECHOSPA cohort.
MedLine Citation:
PMID:  22081446     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To assess the performance of computerized tomography (CT)-scan for ascertaining sacroiliitis in patients with suspected spondyloarthritis (SpA). METHODS: The ECHOSPA French cohort consists of 489 patients with suspected SpA. At baseline, all were submitted to clinical examination, HLA-B typing, and pelvic radiograph. Pelvic CT-scan was performed if sacroiliitis on radiograph was considered uncertain or if patients presented buttock pain duration superior to 6 months. A set of 100 paired radiograph/CT-scan was read blindly by two radiologists, and the kappa coefficient was used to assess their reliability. One of them read the 173 pairs of X-ray/CT-scan available. RESULTS: After training, inter-reader reliability was moderate for sacroiliitis staging on radiograph (kappa = 0.59), excellent on CT-scan (kappa = 0.91), and excellent for ascertaining sacroiliitis on both radiograph (kappa = 1) and CT-scan (kappa = 0.96). Quality of imaging was considered as good in 66% and 67% of the radiographs (kappa = 0.88), and in 93% and 92% of the CT-scans (kappa = 0.93), by readers one and two, respectively. Concordance between radiograph and CT-scan was low for sacroiliitis staging (kappa = 0.08) or ascertainment (kappa = 0.16). Definite sacroiliitis was ascertained in 6 (3.5%) patients on radiograph (4 confirmed by CT-scan), and in 32 (18.5%) on CT-scan. History of uveitis was associated with definite sacroiliitis on radiograph (p = 0.04) and CT-scan (p< 0.0001). CONCLUSIONS: Definite sacroiliitis was underestimated by radiograph, as compared to CT-scan. CT-scan should facilitate the diagnosis of ankylosing spondylitis in patients with suspected SpA.
Authors:
Valérie Devauchelle-Pensec; Maria Antonietta D'Agostino; Julien Marion; Marie Lapierre; Sandrine Jousse-Joulin; Danielle Colin; Isabelle Chary-Valckenaere; Christian Marcelli; Damien Loeuille; Philippe Aegerter; Sandrine Guis; Philippe Gaudin; Maxime Breban; Alain Saraux;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-11
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  -     ISSN:  1529-0131     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 by the American College of Rheumatology.
Affiliation:
Université de Brest, Faculté de Médecine et des Sciences de la Santé, EA 2216; CHU Brest, Department of rheumatology, Brest, F- 29200 France ; Université Européenne de Bretagne, France, BP 814, F 29609 Brest-Cedex.
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