Shouval Aniela, Croitoru Simona, Keret Shiri, Eshed Iris, Slobodin Gleb
Rheumatology Unit, Bnai Zion Medical Center, Haifa, Israel.
Department of Diagnostic Imaging, Bnai Zion Medical Center, Haifa, Israel.
Int J Rheum Dis. 2023 May;26(5):977-981. doi: 10.1111/1756-185X.14568. Epub 2023 Jan 18.
To evaluate structural changes of costovertebral joints (CVJ) in patients with radiographic axial spondyloarthritis (rAxSpA) using computed tomography (CT) studies.
Available chest or thoracic spine CT studies of 17 patients with rAxSpA and 17 patients with rheumatoid arthritis (RA) were analyzed. Ankylosis, erosions, joint space narrowing, and osteophytes were assessed.
The groups were similar by patients' average age, but the rAxSpA group included more males (11/17) compared to the RA group (4/17, p = 0.036). In all, 748 CVJ were assessed in each patient group, including 408 head-vertebral joints (HVJ) and 340 costotransverse joints (CTJ). rAxSpA patients had significantly more total CVJ lesions (p < 0.001 for all comparisons), more lesions in the HVJ (p < 0.001, for all comparisons), and more lesions in the CTJ (p ≤ 0.005, for all comparisons, except for osteophytes), compared to the RA group. All types of lesions, including ankylosis, erosions, narrowing, and osteophytes, were seen more frequently in rAxSpA patients. Joint space narrowing and ankylosis of the CVJ were the most frequently seen findings in rAxSpA and were distributed throughout the thoracic spine.
Structural pathology of the CVJ was more commonly observed in patients with rAxSpA than in RA patients in this study.
利用计算机断层扫描（CT）研究评估影像学轴向脊柱关节炎（rAxSpA）患者肋椎关节（CVJ）的结构变化。
分析了17例rAxSpA患者和17例类风湿关节炎（RA）患者现有的胸部或胸椎CT研究。评估了关节强直、侵蚀、关节间隙变窄和骨赘。
两组患者的平均年龄相似，但rAxSpA组男性（11/17）多于RA组（4/17，p = 0.036）。每组患者均评估了748个CVJ，包括408个头椎关节（HVJ）和340个肋横突关节（CTJ）。与RA组相比，rAxSpA患者的CVJ总病变明显更多（所有比较p < 0.001），HVJ病变更多（所有比较p < 0.001），CTJ病变更多（除骨赘外，所有比较p≤0.005）。rAxSpA患者中所有类型的病变，包括关节强直、侵蚀、变窄和骨赘，均更常见。CVJ的关节间隙变窄和强直是rAxSpA中最常见的表现，且分布于整个胸椎。
在本研究中，rAxSpA患者比RA患者更常观察到CVJ的结构病理学变化。
