THU0406 ULTRASONOGRAPHIC INVOLVEMENT OF THE ANTERIOR CHEST WALL IN SPONDYLOARTHRITIS, A FIVE YEARS FOLLOW UP STUDY

Abstract

Background Spondyloarthrits is characterized by inflammatory back pain. Anterior chest wall pain is common and a previous study reported a prevalence a 37% of ultrasonographic lesions of this anatomical region [1]. Objectives The objective of this study is to evaluate, in patient with Spondyloarthritis, the prevalence of ACW ultrasonographic lesions after a follow up of 5 years and to identify factors associated with the development of new lesions. Methods This a monocentric and prospective study including patients with Spondyloarthritis meeting the ASAS 2009 criteria. Patients were followed during five years. ultrasound B mode and power Doppler examination of the two sternoclavicular joint and the manubrio-sternal joint were performed by the same two examinators at baseline and five years later. The presence of erosion, synovitis, ankylosis, power Doppler signal, joint effusion and bone margin narrowing were assessed. Clinical characteristics and disease activity were evaluated at 5 years. Results In the 136 patients at baseline, 58 patients were evaluated 5 years later. The mean age was 48.2 +/- 11.9 years old, with 86% male and 89% HLA B27. 60.3% of these patients had a history of pain of the ACW. The prevalence of ultrasonographic involvement of the ACW was 34% at baseline and 67.2% five years later. The most frequent lesions were ankylosis of the manubriosternal joint (38%) and erosions of the sternoclavicular joint (29%). At 5 years, patients with lesions of the ACW are significantly older (51.4 +/- 11.5 VS 41.5 +/- 9.98, p Conclusion The prevalence of ultrasonographic lesions of the ACW increased after 5 years of follow up. The development of new lesions is associated with a higher disease activity, a higher CRP and an increased disease activity over 5 years.