Demographic, Clinical and Imaging Characteristics of Axial Spondyloarthritis in Egyptian Patients

Abstract Introduction Axial spondyloarthritis (axSpA) is a chronic, immune-mediated inflammatory disorder involving the sacroiliac (SI) joints and spine but can also involve entheses and peripheral joints. It encompasses both radiographic axial SpA (r-axSPA) and non-radiographic axial SpA (nr-axSPA), which are differentiated based upon the presence or absence of radiographic sacroiliitis, respectively. Aim To study the demographic features, clinical manifestations and imaging characteristics of axSpA in a cohort of Egyptian patients and to assess the differences between r-axSPA and nr- axSpA. Patients and Methods This cross sectional study was conducted on 80 patients who fulfilled the ASAS classification criteria for axSpA collected from Rheumatology outpatient clinic of Ain Shams University hospitals. Patients were further classified as r-axSpA or nr-axSpA based on radiographic findings according to modified New York classification criteria. All Patients were subjected to detailed medical history, assessment of disease activity, laboratory investigations & imaging. Results This study showed that the majority of r-axSpA patients were males while the majority of nr-axSpA patients were females. There is a statistically highly significant difference between both groups regarding smoking. hip arthritis was present more frequently in r-axSpA. Disease activity scores and modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) were higher in r- axSpA. There is no significant difference between both groups regarding co-morbidities, age at onset of symptoms, type of first symptoms, age at diagnosis, peripheral arthritis, extra- articular manifestations, family history, type of received drug & Human leukocyte antigen (HLA-B27). Conclusion Demographic features, clinical manifestations and imaging characteristics of axSpA of Egyptian patients are comparable with those of patients from different regions across the world except for low association with HLA-B27 & presentation of psoriasis as the most common extraarticular manifestaions. By comparing r-axSpA and nr-axSPA patients, both groups are significantly different regarding sex, smoking, hip arthritis, disease activity scores (ASDAS, BASDAI & BASFI) and mSASSS. Both groups are nearly similar regarding co-morbidities, age at onset of symptoms, type of first symptoms, age at diagnosis, peripheral arthritis, extra-articular manifestations, family history, type of received drug & HLA-B27.