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Sacroiliac joint involvement in systemic sclerosis.

Didem Arslan Tas1, Fatih Yıldız, Hakan Sakallı

  • 1Rheumatology-Immunology Department, Faculty of Medicine, Cukurova University, Adana, Turkey.

International Journal of Rheumatic Diseases
|May 9, 2014
PubMed
Summary

Sacroiliitis, inflammation of the sacroiliac joint, is a significant concern in systemic sclerosis (SSc) patients, affecting 23% and correlating with inflammatory back pain. This finding highlights the need to consider sacroiliac joint involvement in SSc diagnosis and management.

Keywords:
sacroiliitisspondyloarthropathysystemic sclerosis

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Area of Science:

  • Rheumatology
  • Immunology
  • Radiology

Background:

  • Articular involvement is a major complication for patients with systemic sclerosis (SSc).
  • While common joint sites in SSc are well-documented, sacroiliac joint involvement remains understudied.
  • This study aimed to investigate the prevalence and characteristics of sacroiliac joint involvement in SSc patients.

Purpose of the Study:

  • To evaluate the involvement of the sacroiliac joint in patients diagnosed with systemic sclerosis (SSc).
  • To compare sacroiliac joint involvement in SSc patients with rheumatoid arthritis (RA) patients and healthy controls.
  • To identify risk factors associated with sacroiliac joint involvement in SSc.

Main Methods:

  • Fifty-seven SSc patients, 54 RA patients, and 64 healthy controls underwent anteroposterior pelvic radiography.
  • Radiographs were graded twice by three blinded rheumatologists and re-evaluated by a radiologist using the ASAS scoring method for sacroiliac involvement.
  • Clinical data, including inflammatory back pain and laboratory markers, were collected according to European Study Group guidelines.

Main Results:

  • Sacroiliitis was detected in 23% of SSc patients, significantly higher than in RA patients (4%) and controls (2%).
  • Inflammatory back pain was more frequent in SSc patients with sacroiliitis (62%) compared to those without (9%).
  • Significant risk factors for sacroiliitis in SSc included male gender, diffuse subtype, inflammatory back pain, and elevated C-reactive protein levels.

Conclusions:

  • Sacroiliitis is a notable finding in systemic sclerosis patients, occurring significantly more often than in rheumatoid arthritis or healthy individuals.
  • The presence of sacroiliitis in SSc patients is associated with inflammatory back pain and may indicate axial spondyloarthritis overlap.
  • Clinicians should consider evaluating sacroiliac joint involvement in the systemic sclerosis patient population.