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Liao S, Cheng L, Zhao Z, Zhu J, Huang F. Distinct characteristics and progression patterns of facet joint structural lesions in radiographic axial spondyloarthritis. Ther Adv Musculoskelet Dis 2024; 16:1759720X241281201. [PMID: 39371372 PMCID: PMC11450570 DOI: 10.1177/1759720x241281201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 08/21/2024] [Indexed: 10/08/2024] Open
Abstract
Background Both vertebral bodies and posterior elements of the vertebrae (facet joints, FJ) can engage in bone formation in radiographic axial spondyloarthritis (r-axSpA). However, little is known about the specific structural lesions and progression patterns of FJs in r-axSpA. Objectives To identify specific lesions related to r-axSpA and to investigate the distinct progression patterns by comparing the FJ changes of r-axSpA with that of diffuse idiopathic skeletal hyperostosis (DISH), osteoarthritis (OA), and control group (CG). Design Single-center, retrospective study. Longitudinal imaging data were retrieved and collected. Methods Age- and sex-matched patients with complete thoracic and lumbar spine computed tomography (CT) data were included and their bilateral FJs were assessed. FJ changes were divided into erosions, ankylosis, joint-space narrowing, osteophytes, subchondral sclerosis, subchondral cysts, and vacuum phenomena. Average progressed year was defined as "number of changed vertebrae × interval years"/number of changed vertebrae. Results In all, 50 patients in each group were included. Subchondral cysts and vacuum phenomena were not observed. Bilateral FJ ankylosis (FJA)/erosions in the thoracic and lumbar spine, and unilateral ankylosis/erosions in T1-4, T9-12 were significantly more common in r-axSpA. Joint-space narrowing/osteophytes/subchondral sclerosis were significantly more common in DISH and OA. FJ lesions progressed in 56.34% of vertebrae of r-axSpA. The most common pattern was "FJ normal advanced to ankylosis" (17.54%) which required 2.63 years. It was followed by "erosions advanced to ankylosis" (12.3%) which took 2.05 years, and by "normal FJ advanced to erosions" (11.04%) which took 2.29 years, respectively. Degenerative changes could also progress to FJ erosions/ankylosis (24.83%). The majority pattern in DISH/OA was "FJ changes advanced to subchondral sclerosis/osteophytes/joint-space narrowing." Conclusion Bilateral FJA/erosions are r-axSpA-specific lesions. The specific progression pattern for r-axSpA was "FJ changes advanced to ankylosis/erosions." Repeated CT examination in intervals of at least 2 years will be more appropriate for monitoring FJ progression.
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Affiliation(s)
- Simin Liao
- Department of Rheumatology and Immunology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Liuquan Cheng
- Department of Radiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zheng Zhao
- Department of Rheumatology and Immunology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jian Zhu
- Department of Rheumatology and Immunology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Feng Huang
- Department of Rheumatology and Immunology, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
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Liao S, Shang J, Cheng L, Zhu J, Huang F. A higher body mass index and increased syndesmophytes volume are associated with facet joints ankylosis on thoracic spine in patients with ankylosing spondylitis: a retrospective cohort study. BMC Rheumatol 2024; 8:44. [PMID: 39300556 PMCID: PMC11411733 DOI: 10.1186/s41927-024-00408-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 08/16/2024] [Indexed: 09/22/2024] Open
Abstract
OBJECTIVE To investigate the association between syndesmophytes and facet joint (FJ) lesions in patients with ankylosing spondylitis (AS), and to identify clinical factors associated with FJ ankylosis (FJA) in thoracic segment. METHODS Ninety-seven patients with AS who underwent thoracic spine computed tomography (CT) or chest CT and without completely thoracic spine fusion were included. FJ lesions were analyzed for the numbers and distribution of normal, ankylosis, erosions, joint-space narrowing, osteophytes, and subchondral sclerosis. The volume of vertebral syndesmophtes unit (VSU) and total thoracic syndesmophtes volume were separately calculated by Mimics software. Clinical factors associated with FJA were investigated using generalized estimation equation (GEE). The association between syndesmophtes volume and numbers of FJ structural lesions was analyzed using generalized additive mixed model (GAMM). RESULTS 2328 FJ and 1164 VSUs in thoracic spine were assessed. The majority FJ structural lesions were ankylosis (32.39%). FJA was more frequently seen in vertebrae with syndesmophytes formation (p < 0.001). GEE showed that patients with normal BMI (18.5-24.9 kg/m2) and high BMI (> 24.9 kg/m2) were more likely to have FJA in thoracic spine (odds rations [95% confidence interval]: 0.27(0.12-0.59), 1.45(1.03-8.57), respectively). GAMM showed that syndesmophytes volume increase the numbers of FJA (standard β = 0.009, p < 0.05) and decreased the numbers of normal FJ (standard β = -0.07, p < 0.01). CONCLUSION FJA was the most common FJ structural lesion in thoracic spine, and it increases linearly with syndesmophytes before the bridging syndesmophytes formed. A higher BMI (especially > 24.9 kg/m2) and increased syndesmophytes volume are associated with FJA in thoracic spine.
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Affiliation(s)
- Simin Liao
- Department of Rheumatology and Immunology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jian Shang
- Department of Rheumatology and Endocrinology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Liuquan Cheng
- Department of Radiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jian Zhu
- Department of Rheumatology and Immunology, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
| | - Feng Huang
- Department of Rheumatology and Immunology, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
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Shirota S, Nishioka H. Lumbar facet arthritis after coronavirus disease 2019 vaccination-Utilization of ultrasound. Int J Rheum Dis 2024; 27:e15269. [PMID: 39022915 DOI: 10.1111/1756-185x.15269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/20/2024] [Accepted: 07/10/2024] [Indexed: 07/20/2024]
Affiliation(s)
- Shogo Shirota
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki, Japan
- Department of General Internal Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Hiroaki Nishioka
- Department of General Internal Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
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Tanaviriyachai T, Pornsopanakorn P, Choovongkomol K, Virathepsuporn T, Piyapromdee U, Jongkittanakul S, Sudprasert W, Wiwatrojanagul S. A Comparative Factor Analysis and New Magnetic Resonance Imaging Scoring System for Differentiating Pyogenic Versus Tuberculous Spondylodiscitis. Neurospine 2024; 21:690-700. [PMID: 38955538 PMCID: PMC11224736 DOI: 10.14245/ns.2448120.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/04/2024] [Accepted: 04/12/2024] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVE This study aimed to compare and analyze differences in clinical and magnetic resonance imaging (MRI) findings between tuberculous spondylodiscitis (TbS) and pyogenic spondylodiscitis (PyS), and to develop and validate a simplified multiparameter MRIbased scoring system for differentiating TbS from PyS. METHODS We compared predisposing factors in 190 patients: 123 with TbS and 67 with PyS, confirmed by laboratory tests, culture, or pathology. Data encompassing patient demographics, clinical characteristics, laboratory results, and MRI findings were collected between 2015 and 2020. Data were analyzed using logistic regression methods, and selected coefficients were transformed into an MRI-based scoring system. Internal validation was performed using bootstrapping method. RESULTS Univariate analysis revealed that the significant risk factors associated with TbS included thoracic lesions, vertebral destruction > 50%, intraosseous abscess, thin-walled abscess, well-defined paravertebral abscess, subligamentous spreading, and epidural abscess. Multivariate analysis revealed that only thoracic lesions, absence of epidural phlegmon, subligamentous spreading, intraosseous abscesses, well-defined paravertebral abscesses, epidural abscesses, and absence of facet joint arthritis were independent predictive factors for TbS (all p < 0.05). These potential predictors were used to derive an MRI scoring system. Total scores ≥ 14/29 points significantly predicted the probability of TbS, with a sensitivity of 97.58%, specificity of 92.54%, and an area under the curve of 0.96 (95% confidence interval, 125.40-3,257.95). CONCLUSION This simplified MRI-based scoring system for differentiating TbS from PyS helps guide appropriate treatment when the causative organism is not identified.
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Affiliation(s)
- Terdpong Tanaviriyachai
- Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
| | - Patchara Pornsopanakorn
- Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
| | - Kongtush Choovongkomol
- Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
| | | | - Urawit Piyapromdee
- Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
| | - Sarut Jongkittanakul
- Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
| | - Weera Sudprasert
- Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
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Scholten P, Sheikh M, Atchison J, Eldrige JS, Garcia D, Sandhu S, Qu W, Nottmeier E, Fox WC, Buchanan I, Pirris S, Chen S, Quinones-Hinojosa A, Abode-Iyamah K. Correlating SPECT-CT activity in cervical facet joints with positive response to cervical medial branch blocks. INTERVENTIONAL PAIN MEDICINE 2024; 3:100393. [PMID: 39239492 PMCID: PMC11373050 DOI: 10.1016/j.inpm.2024.100393] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/10/2024] [Accepted: 02/11/2024] [Indexed: 09/07/2024]
Abstract
Introduction Cervical facet arthritis is a significant source of neck pain and impaired function that is amenable to treatment with medial branch radiofrequency neurotomy (RFN). Identifying appropriate patients for this treatment requires integration of information from the history, physical exam and diagnostic imaging, but the current diagnostic standard for facet-mediated pain is positive comparative medial branch blockade (MBB). SPECT-CT has recently been evaluated as a potential predictor of positive medial branch blocks with mixed results. The purpose of this retrospective analysis was to determine if a relationship exists between increased uptake on SPECT-CT of a given cervical facet joint and a positive MBB. Methods A retrospective review was performed to identify all patients undergoing cervical MBB within 12 months after having a cervical SPECT-CT. Each procedure was categorized as either Concordant (all facet joints demonstrating increased 99mTc uptake on SPECT-CT were blocked) or Discordant (at least one facet joint demonstrating increased 99mTc uptake on SPECT-CT was not blocked or block was performed in a patient that had no increased uptake on SPECT-CT). Statistical analysis was performed to determine if concordance between facet joints demonstrating increased uptake on SPECT-CT and those undergoing MBB was associated with a positive block using cutoffs of 50% and 80% pain relief. Results A total of 43 procedures were analyzed (25% Concordant, 75% Discordant) and both groups demonstrated improvement in pain Numeric Rating Scale (NRS) scores. No significant association between concordance and positive MBB was identified at thresholds of 50% (p = .481) and 80% (p = 1.000) pain relief. Conclusion SPECT-CT findings do not accurately predict positive cervical MBB but may provide valuable information that can be considered with other factors when deciding which joints to treat.
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Affiliation(s)
- Paul Scholten
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Mateen Sheikh
- University of North Florida, 1 UNF Dr., Jacksonville, FL, 32224, USA
| | - James Atchison
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Jason S Eldrige
- Department of Pain Medicine, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Diogo Garcia
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Sukhwinder Sandhu
- Department of Neuroradiology, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Wenchun Qu
- Department of Pain Medicine, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Eric Nottmeier
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - W Christopher Fox
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Ian Buchanan
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Stephen Pirris
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Selby Chen
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Alfredo Quinones-Hinojosa
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Kingsley Abode-Iyamah
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
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Scholten P, Sheikh M, Atchison J, Eldrige JS, Garcia D, Sandhu S, Qu W, Nottmeier E, Fox WC, Buchanan I, Pirris S, Chen S, Quinones-Hinojosa A, Abode-Iyamah K. Correlating SPECT-CT activity in lumbar facet joints with response to lumbar medial branch and L5 dorsal ramus blocks. INTERVENTIONAL PAIN MEDICINE 2024; 3:100387. [PMID: 39239486 PMCID: PMC11372969 DOI: 10.1016/j.inpm.2024.100387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/30/2023] [Accepted: 01/15/2024] [Indexed: 09/07/2024]
Abstract
Introduction Lumbar facet arthritis is a significant source of back pain and impaired function that is amenable to treatment with medial branch radiofrequency neurotomy (RFN). Identifying appropriate patients for this treatment requires integration of information from the history, physical exam, and diagnostic imaging, but the current diagnostic standard for facet-mediated pain is positive comparative medial branch blocks (MBBs). Lumbar SPECT-CT has recently been evaluated as a potential predictor of positive MBBs with mixed results. The purpose of this retrospective analysis was to determine if the level of concordance between SPECT-CT uptake and facet joints targeted with MBB was associated with a positive block. Methods A retrospective review was performed to identify all patients undergoing lumbar MBB within 12 months after having a lumbar SPECT-CT. Each procedure was classified into one of four categories based on the level of concordance between facet joints demonstrating increased 99mTc uptake on SPECT-CT and those being blocked: 1) Complete Concordance (all joints demonstrating increased uptake were blocked and no additional joints blocked); 2) Partial Concordance (all joints demonstrating increased uptake were blocked, with at least one joint not demonstrating increased uptake blocked); 3) Partial Discordance (at least one but not all joints demonstrating increased uptake were blocked); 4) Complete Discordance (all blocks performed at joints not demonstrating increased uptake). Statistical analysis was performed to determine if the level of concordance between increased uptake on SPECT-CT and joints undergoing MBB was associated with a positive block using cutoffs of 50 % and 80 % pain relief. Results A total of 180 procedures were analyzed (23 % Complete Concordance, 22 % Partial Concordance, 31 % Partial Discordance, 24 % Complete Discordance) and all groups demonstrated improvement in pain Numeric Rating Scale (NRS) scores. There was no significant association between level of concordance and having a positive block using thresholds of 50 % pain relief, χ 2(3, N = 180) = 4.880, p = .181; or 80 % pain relief, χ 2(3, N = 180) = 1.272, p = .736. Conclusion SPECT-CT findings do not accurately predict positive lumbar MBB but may provide valuable information that can be considered with other factors when deciding which joints to treat.
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Affiliation(s)
- Paul Scholten
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Mateen Sheikh
- University of North Florida, 1 UNF Dr., Jacksonville, FL, 32224, USA
| | - James Atchison
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Jason S Eldrige
- Department of Pain Medicine, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Diogo Garcia
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Sukhwinder Sandhu
- Department of Neuroradiology, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Wenchun Qu
- Department of Pain Medicine, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Eric Nottmeier
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - W Christopher Fox
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Ian Buchanan
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Stephen Pirris
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Selby Chen
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Alfredo Quinones-Hinojosa
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Kingsley Abode-Iyamah
- Departement of Neurologic Surgery, Mayo Clinic Florida, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
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Eede NVD, Friedrich KM, Hauwe LVD. Imaging the Posterior Elements of the Spine. Semin Musculoskelet Radiol 2023; 27:553-560. [PMID: 37816363 DOI: 10.1055/s-0043-1770996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
The posterior elements of the spine consist of the pedicles, laminae, facets (articular processes), transverse processes, and the spinous process. They are essential for spinal stability, protecting the spinal cord and nerve roots, and enabling movement of the spine. Pathologies affecting the posterior elements can cause significant pain and disability. Imaging techniques, such as conventional radiography, computed tomography, and magnetic resonance imaging, are crucial for the diagnosis and evaluation of pathology, enabling accurate localization, characterization, and staging of the disease.
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Affiliation(s)
- Nick Van den Eede
- Department of Radiology, Antwerp University Hospital, Antwerp, Belgium
- Department of Radiology, AZ KLINA, Brasschaat, Belgium
| | - Klaus M Friedrich
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Luc van den Hauwe
- Department of Radiology, Antwerp University Hospital, Antwerp, Belgium
- Department of Radiology, AZ KLINA, Brasschaat, Belgium
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Zhang N, Ji C, Bao X, Yuan C. Development and assessment of a predictive model for early diagnosis of rheumatoid arthritis in southwest China: A new nomogram. Medicine (Baltimore) 2023; 102:e33386. [PMID: 36961142 PMCID: PMC10036016 DOI: 10.1097/md.0000000000033386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023] Open
Abstract
Rheumatoid arthritis (RA) is a disease complicated with inflammatory synovitis, which seriously affects the life quality of patients. Early diagnosis is important for prognosis of RA. Here, we aimed to develop and assess a model for early diagnosis of RA in southwest China. A nomogram including 44 patients with an early diagnosis of RA was developed. Variables were filtered by least absolute contraction selection operator and multiple logistic regression. The efficiency and clinical application range were evaluated. This nomogram showed that rheumatoid factor, erythrocyte sedimentation rate, RA33, facet joint and knee joint had high positive predictive value for RA. The area under curve was 0.920 [95% confidence interval (CI): 0.865-0.975]. In the validation model, area under curve was 0.942 (95% CI: 0.893-0.991). Calibration and decision curve suggested that this nomogram was helpful within the threshold probability range of 0.02 to 1.00. Using this nomogram will help clinicians in the early diagnosis of RA. Laboratory indicators such as rheumatoid factor, erythrocyte sedimentation rate, RA33, and clinical symptoms such as morning stiffness, facet joint and knee joint are very important, which deserves the attention of clinicians.
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Affiliation(s)
- Naidan Zhang
- Department of Clinical Laboratory, Peoples Hospital of Deyang City, Deyang, China
| | - Chaixia Ji
- Department of Clinical Laboratory, Peoples Hospital of Deyang City, Deyang, China
| | - Xiao Bao
- Department of Rheumatology, Peoples Hospital of Deyang City, Deyang, China
| | - Chengliang Yuan
- Department of Clinical Laboratory, Peoples Hospital of Deyang City, Deyang, China
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Ogut E, Karakas O, Aydin DD. Oppenheimer's accessory ossicle and clinical significance: A narrative review. JOURNAL OF ORTHOPAEDIC REPORTS 2022; 1:100069. [DOI: https:/doi.org/10.1016/j.jorep.2022.100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
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10
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Slobodin G, Sagiv M, Khreish T, Croitoru S, Shouval A, Eshed I. Facet joint disease in patients with axial spondyloarthritis: a retrospective computed tomography study. Semin Arthritis Rheum 2022; 55:151991. [DOI: 10.1016/j.semarthrit.2022.151991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/22/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
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