الفهرس | Only 14 pages are availabe for public view |
Abstract Psoriatic arthritis (PsA) is a chronic inflammatory disease, it is one of the five types of spondyloarthropathies (SpAs). PsA commonly develops when patients are 30 to 50 years. PsA can cause physical disability that results from bone erosions and joint destruction. Joint inflammation can affect either axial or peripheral anatomical regions or both. The axial type primarily involves the spine and sacroiliac joints, the diagnosis is confirmed by physical examination and imaging revealing (sacroiliitis, spinal ossifications). The aim of this study was to assess characteristics of axial PsA, associated risk factors and comorbidities. This study was conducted on 100 PsA patients diagnosed according to CASPAR criteria. All patients were recruited from rheumatology outpatient clinic and inpatient departments in Ain Shams university hospital with mean (SD) age of (41.57±11.85) years, mean (SD) disease onset of skin psoriasis of (23.26±3.08) years and mean (SD) disease duration of PsA of (8.01±5.60) years. All patients were subjected to full medical history, full examination, basic lab tests as ESR, CRP, CBC, liver function tests, serum creatinine and serum uric acid, disease activity scores (ASDAS-ESR, ASDAS-CRP, BASDAI, DAPSA, PASI), functional assessment scores (BASFI, BASMI, HAQ, VAS), finally radiological scores (PASRI, PARS). Our PsA studied patients were classified according to axial joint affection into 2 groups: (group (A) included 51 PsA patients without axial joint affection and group (B) included 49 PsA patients with axial joint affection. In comparison between PsA patients with and without axial joint affection we reported that: Patients with axial joint afeection had higher percentage of smokers, more positive family history of psoriasis or PsA, longer disease duration, younger at the onset of skin psoriasis, more duration of morning stiffness, more dactylitis and enthesitis. In addition, higher (BASDAI, DAPSA, ASDAS-ESR, ASDAS-CRP, BASFI, BASMI, HAQ, VAS and PASRI) scores and higher inflammatory markers. Our study showed that the predictors for having axial joint affection were smoking, disease onset of skin psoriasis ≤ 18 years, disease duration of PsA > 6 years, family history of psoriasis or PsA, morning stiffness > 20 minutes, DAPSA score >42, ASDAS-ESR score >3.2, ASDAS- CRP score > 3, BASDAI score > 4.2, BASMI score > 0.9, BASFI score > 4.4, PASRI score > 0, HAQ score >1, ESR> 38, CRP >23 by univariate logistic analysis. The multivariate logistic regression analysis showed that the factors associated with axial PsA were the HAQ>1 score followed by disease duration> 6years, finally enthesitis. |