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Undifferentiated spondyloarthropathies: a 2-year follow-up study
P D Sampaio-Barros1, M B Bertolo, M H Kraemer
1Depto. de Clinica Médica, State University of Campinas Faculty of Medical Sciences, SP, Brazil. psbarros@bestway.com.br
Clinical Rheumatology
|July 4, 2001
Summary
Undifferentiated spondyloarthropathy (uSpA) often evolves into definite spondyloarthropathies (SpA). A 2-year follow-up study found that inflammatory back pain and HLA-B27 positivity are key indicators for progression in SpA patients.
Area of Science:
- Rheumatology
- Immunology
- Clinical Medicine
Background:
- Undifferentiated spondyloarthropathy (uSpA) is a challenging diagnosis.
- Understanding its progression is crucial for patient management.
Purpose of the Study:
- To analyze the 2-year follow-up outcomes of patients diagnosed with symptomatic uSpA.
- To identify factors associated with disease progression.
Main Methods:
- Prospective study of 68 patients meeting European Spondylarthropathy Study Group (ESSG) criteria.
- Inclusion criteria: inflammatory low back pain, asymmetric oligoarthritis, heel enthesopathies.
- Imaging: pelvic and calcaneal radiography; logistic regression for outcome analysis.
Main Results:
- Predominance of male gender (78%), caucasoid race (72%), and HLA-B27 positivity (54%).
- Common initial manifestations: inflammatory low back pain (49%), asymmetric oligoarthritis (35%), heel enthesopathies (16%).
- After 2 years: 75% remained uSpA, 13% achieved remission, 10% progressed to ankylosing spondylitis, 2% to psoriatic arthritis.
Conclusions:
- uSpA can be a provisional diagnosis within the spondyloarthropathies (SpA) spectrum.
- Systematic follow-up is essential for accurate diagnosis and management.
- Buttock pain and a trend towards HLA-B27 positivity are associated with progression to definite SpA.