Gender Differences in Clinical and Radiological Features Amongst Patients with Axial Spondyloarthropathy

Objective: To identify gender based clinical and radiological differences in patients with axial spondyloarthropathy. Study Design: Comparative, cross-sectional study. Place and Duration of Study: Rheumatology Department, Fauji Foundation Hospital, Rawalpindi Pakistan, from june to Dec 2021. Methodology: 100 patients (50 males and 50 females) were selected, who were diagnosed with axial spondyloarthropathy according to Assessment of Spondylarthritis international society criteria. Demographic data, clinical characteristics, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, X-ray and magnetic resonance imaging findings of sacroiliac joints were recorded. Gender groups were compared using Student t-test, chi square and regression analysis. Results: The mean age was 35.32±8.66 in males and35.46±9.28 in females. Females had higher involvement of cervico-thoracic region (OR= 4.82, p =0.01, 95% CI: 0.96-24.06), peripheral arthritis (OR= 3.18, p =0.007, 95% CI: 0.13-0.72), delay in diagnosis (OR= 3.55, p <001, 95% CI: 2.23-5.67), enthesitis (OR= 4.37, p =0.001, 95%CI:0.09-0.53). The mean Bath ankylosing spondylitis disease activity score was higher in females (OR= 1.36, p =0.002, 95% CI: 1.12-1.64). Mean Bath ankylosing spondylitis functional index was 5.22±2.3. Smoking in males had a significant correlation with disease. Males had more severe radiographic involvement. Conclusion: Females with axial spondyloarthropathy are found to have a higher disease activity, more frequent cervico-thoracic pain, peripheral arthritis and enthesitis as compared to males. Males have more advanced radiographic involvement of sacroiliac joint.