Thoracic Syndesmophytes Commonly Occur in the Absence of Lumbar Syndesmophytes in Ankylosing Spondylitis: A Computed Tomography Study.
Ontology highlight
ABSTRACT: Objective
To determine the extent of thoracic involvement with syndesmophytes in ankylosing spondylitis (AS) relative to lumbar involvement.Methods
We performed thoracolumbar spine computed tomography (CT) and lumbar radiography on 18 patients. We quantitated syndesmophytes in 11 intervertebral disc spaces and related these to the presence of syndesmophytes on lumbar radiographs.Results
Syndesmophytes were slightly more common in the thoracic than in the lumbar spine and bridging was significantly more common. Thoracic syndesmophytes were universally present in patients without visible lumbar syndesmophytes on either radiographs or CT.Conclusion
Syndesmophytes predominate in the thoracic spine. Lumbar radiographs underestimate the degree of thoracic involvement.
SUBMITTER: Tan S
PROVIDER: S-EPMC11210185 | biostudies-literature | 2017 Dec
REPOSITORIES: biostudies-literature
Publications
Thoracic Syndesmophytes Commonly Occur in the Absence of Lumbar Syndesmophytes in Ankylosing Spondylitis: A Computed Tomography Study.
Tan Sovira S Yao Lawrence L Ward Michael M MM
The Journal of rheumatology 20171001 12
<h4>Objective</h4>To determine the extent of thoracic involvement with syndesmophytes in ankylosing spondylitis (AS) relative to lumbar involvement.<h4>Methods</h4>We performed thoracolumbar spine computed tomography (CT) and lumbar radiography on 18 patients. We quantitated syndesmophytes in 11 intervertebral disc spaces and related these to the presence of syndesmophytes on lumbar radiographs.<h4>Results</h4>Syndesmophytes were slightly more common in the thoracic than in the lumbar spine and ...[more]
Similar Datasets
Project description:Introduction and objectiveAnkylosing spondylitis (AS) has characteristics of spinal bone bridge and fusion. Although BMD reduction in AS may be presumed to be due to spinal inflammation, this study was designed to confirm whether immobilization of the spine due to syndesmophytes is related to BMD reduction, as immobilization itself is a risk factor for BMD reduction.MethodsAmong male patients diagnosed with AS according to the modified New York criteria, those who underwent bone density tests with quantitative computed tomography (QCT) were retrospectively analyzed through a chart review. The correlation between the presence or absence of bone bridges for each vertebral body level of the L spine confirmed with radiography and BMD confirmed with QCT was analyzed.ResultsA total of 47 male patients with AS were enrolled. The mean patient age was 46.8 ± 8.2 years, and the mean disease duration was 7.9 ± 6.4 years. The trabecular BMD of the lumbar spine (L1-L4) ranged from 23.1 to 158.45 mg/cm3 (mean 102.2 ± 37 mg/cm3), as measured with QCT. The lumbar BMD measurements showed that 30 patients (63.8%) had osteopenia or osteoporosis. Bone bridge formation showed a negative correlation with BMD. Low BMD was significantly correlated with bone bridge in the vertebral body (p < 0.05). Positive correlations were observed between bone bridge score and BASMI flexion score, whereas significant negative correlations were found between BMD and BASMI flexion score (p < 0.05).ConclusionDecreased mobility of the vertebrae due to bone bridge formation affects the decrease in BMD in patients with AS.
| S-EPMC8051772 | biostudies-literature
Project description:BackgroundTo compare changes in the composition of paraspinal muscles of patients with ankylosing spondylitis (AS) and matched healthy controls using T2 mapping and T2 IDEAL and correlate the quantitative magnetic resonance imaging (qMRI) results with clinical assessments of AS patients.MethodIn total, 37 AS patients and 37 healthy controls were enrolled in the case control study. T2 mapping with and without fat saturation and IDEAL imaging were used to assess the multifidus (MF) and erector spinae (ES) at the levels of L3/L4 and L4/L5 for all subjects. Mean T2non-fatsat, T2fat, T2fatsat, cross-sectional area (CSA), and fat fraction (FF) were compared between AS and healthy controls. Correlations of qMRI results with clinical assessments were analyzed in AS.ResultsSignificantly elevated mean T2non-fatsat values and the FF of the MF and ES at both levels were observed in AS and compared to the controls (p < 0.05). The mean T2fatsat values of ES and MF were significantly higher only at the level of L3/L4 in AS compared to healthy controls (p < 0.05). A loss of muscle CSA compatible with atrophy was present in MF and ES at both levels in AS compared to the controls (p < 0.05). Weak to moderate positive correlations were found between FF and age and disease duration in AS (r = 0.318-0.415, p < 0.05). However, such positive correlation was not observed between FF and disease duration after adjusting for age (p > 0.05).ConclusionsOur findings indicate that using a combination of IDEAL and T2 mapping may provide deeper insights into the pathophysiological degeneration of paraspinal muscles in AS.
| S-EPMC9235229 | biostudies-literature
Project description:IntroductionRheumatoid arthritis (RA) and ankylosing spondylitis (AS) are associated with osteoporosis. There have not been many peripheral quantitative computed tomography (QCT) studies in patients receiving biologics. We assessed volumetric and areal bone mineral density (BMD) by forearm QCT and dual-energy X-ray absorptiometry (DXA), respectively in addition to laboratory biomarkers in these arthritides.MethodsForty RA and AS patients treated with either etanercept (ETN) or certolizumab pegol (CZP) were undergoing follow-ups for one year. Volumetric and areal BMD, as well as parathyroid hormone (PTH), osteocalcin, RANKL, 25-hydroxyvitamin D (VITD), P1NP, CTX, sclerostin (SOST), Dickkopf 1 (DKK-1) and cathepsin K (CATHK) were determined.ResultsWe did not observe any further bone loss during the 12-month treatment period. Volumetric and areal BMD showed significant correlations with each other (p<0.017 after Bonferroni's correction). Trabecular QCT BMD at baseline (p=0.015) and cortical QCT BMD after 12 months (p=0.005) were inversely determined by disease activity at baseline in the full cohort. Trabecular QCT BMD at baseline also correlated with CTX (p=0.011). In RA, CRP negatively (p=0.014), while SOST positively (p=0.013) correlated with different QCT parameters. In AS, RANKL at baseline (p=0.014) and after 12 months (p=0.007) correlated with cortical QCT BMD. In the full cohort, 12-month change in QTRABBMD was related to TNF inhibition together with elevated VITD-0 levels (p=0.031). Treatment and lower CATHK correlated with QCORTBMD changes (p=0.006). In RA, TNF inhibition together with VITD-0 (p<0.01) or CATHK-0 (p=0.002), while in AS, treatment and RANKL-0 (p<0.05) determined one-year changes in QCT BMD.ConclusionsBMD as determined by QCT did not change over one year of anti-TNF treatment. Disease activity, CATHK, RANKL and VITD may be associated with the effects of anti-TNF treatment on QCT BMD changes. RA and AS may differ in this respect.
| S-EPMC8461899 | biostudies-literature
Project description:Anemia is a major global disease burden factor linked to an adverse impact on overall prognosis and negatively affects the quality of life. There are some suggested findings for anemia on non-contrast chest CT, like relatively dense interventricular septum (septal sign) or fairly dense aortic wall (aortic ring sign). The measured attenuation value is a reproducible physical density measurement, readily obtainable from a standard CT examination. There is no reliable cut-off for blood attenuation to suggest anemia on the non-contrast chest CT. In the current study, we evaluated subjective and objective criteria' diagnostic accuracy for diagnosing anemia on unenhanced thoracic CT. This study is approved by Mashhad University of Medical Sciences. The patients admitted in the internal medicine ward of our hospital from June 2019 to March 2020 for whom a non-contrast chest CT was acquired for any non-traumatic medical indication, were enrolled in this retrospective study. For the subjective assessment, the radiologists were asked to record the presence or absence of the "aortic ring sign" and "interventricular septum sign". For the objective evaluations, blood density was measured at various anatomic locations. A total of 325 patients were included in this study. There was a significant correlation between blood attenuation in all measured segments and Hb level (0.78 (R2: 0.61), p = 0.000). Findings revealed that considering the aortic arch threshold value as 20 HU is the best diagnostic performance for detecting severe anemia. Subjective analysis revealed that the aortic ring sign was more sensitive (82.5%) than the interventricular septum sign (32%) in detecting anemia, whereas the latter character was more specific (87% and 99.2%, respectively). The results suggest that it is possible to detect anemia from an unenhanced chest CT scan. Both objective and subjective criteria show promising sensitivity and specificity.
| S-EPMC9741598 | biostudies-literature
Project description:BackgroundThe work incapacity of ankylosing spondylitis (AS) ranges between 3% and 50% in Europe. In many countries, work incapacity is difficult to quantify. The work ability index (WAI) is applied to measure the work ability in workers, but it is not well investigated in patients.AimsTo investigate the work incapacity in terms of absence days in patients with AS and to evaluate whether the WAI reflects the absence from work.HypothesisAbsence days can be estimated based on the WAI and other variables.DesignCross-sectional design.SettingIn a secondary care centre in Switzerland, the WAI and a questionnaire about work absence were administered in AS patients prior to cardiovascular training. The number of absence days was collected retrospectively. The absence days were estimated using a two-part regression model.Participants92 AS patients (58 men (63%)).Inclusion criteriaAS diagnosis, ability to cycle, age between 18 and 65 years.Exclusion criteriasevere heart disease.Primary and secondary outcome measuresAbsence days.ResultsOf the 92 patients, 14 received a disability pension and 78 were in the working process. The median absence days per year of the 78 patients due to AS alone and including other reasons was 0 days (IQR 0-12.3) and 2.5 days (IQR 0-19), respectively. The WAI score (regression coefficient=-4.66 (p<0.001, CI -6.1 to -3.2), 'getting a disability pension' (regression coefficient=-106.8 (p<0.001, 95% CI -141.6 to -72.0) and other not significant variables explained 70% of the variance in absence days (p<0.001), and therefore may estimate the number of absence days.ConclusionsAbsences in our sample of AS patients were equal to pan-European countries. In groups of AS patients, the WAI and other variables are valid to estimate absence days with the help of a two-part regression model.
| S-EPMC3612752 | biostudies-literature
Project description:We seek to use computed tomography (CT) to characterize regional lung parenchymal deformation during high-frequency and multi-frequency oscillatory ventilation. Periodic motion of thoracic structures results in artifacts of CT images obtained by standard reconstruction algorithms, especially for frequencies exceeding that of the X-ray source rotation. In this paper, we propose an acquisition and reconstruction technique for high-resolution imaging of the thorax during periodic motion. Our technique relies on phase-binning projections according to the frequency of subject motion relative to the scanner rotation, prior to volumetric reconstruction. The mathematical theory and limitations of the proposed technique are presented, and then validated in a simulated phantom as well as a living porcine subject during oscillatory ventilation. The 4-D image sequences obtained using this frequency-selective reconstruction technique yielded high-spatio-temporal resolution of the thorax during periodic motion. We conclude that the frequency-based selection of CT projections is ideal for characterizing dynamic deformations of thoracic structures that are ordinarily obscured by motion artifact using conventional reconstruction techniques.
| S-EPMC5639881 | biostudies-literature
Project description:Knowledge of the lung vessel morphology in healthy subjects is necessary to improve our understanding about the functional network of the lung and to recognize pathologic deviations beyond the normal inter-subject variation. Established values of normal lung morphology have been derived from necropsy material of only very few subjects. In order to determine morphologic readouts from a large number of healthy subjects, computed tomography pulmonary angiography (CTPA) datasets, negative for pulmonary embolism, and other thoracic pathologies, were analyzed using a fully-automatic, in-house developed artery/vein separation algorithm. The number, volume, and tortuosity of the vessels in a diameter range between 2 and 10 mm were determined. Visual inspection of all datasets was used to exclude subjects with poor image quality or inadequate artery/vein separation from the analysis. Validation of the algorithm was performed manually by a radiologist on randomly selected subjects. In 123 subjects (men/women: 55/68), aged 59 ± 17 years, the median overlap between visual inspection and fully-automatic segmentation was 94.6% (69.2-99.9%). The median number of vessel segments in the ranges of 8-10, 6-8, 4-6, and 2-4 mm diameter was 9, 34, 134, and 797, respectively. Number of vessel segments divided by the subject's lung volume was 206 vessels/L with arteries and veins contributing almost equally. In women this vessel density was about 15% higher than in men. Median arterial and venous volumes were 1.52 and 1.54% of the lung volume, respectively. Tortuosity was best described with the sum-of-angles metric and was 142.1 rad/m (138.3-144.5 rad/m). In conclusion, our fully-automatic artery/vein separation algorithm provided reliable measures of pulmonary arteries and veins with respect to age and gender. There was a large variation between subjects in all readouts. No relevant dependence on age, gender, or vessel type was observed. These data may provide reference values for morphometric analysis of lung vessels.
| S-EPMC5932382 | biostudies-literature
Project description:New methods of dosimetry in computed tomography (CT) X-ray fields require the use of high-resolution detectors instead of pencil-type ionization chambers typically used for CT dose index (CTDI) measurements. This paper presents a study on the suitability of a wide range of ionization chambers, diodes, and a two-dimensional detector array, used primarily in radiation therapy, for CT and cone-beam CT dosimetry. Specifically, the energy dependence of these detectors from 50 kVp up to 125 kVp is reported. All measurements were performed in reference to a calibrated diode for use in this energy region. The radiation quality correction factors provided by the manufacturer were used, depending on the measured half-value layer (HVL) for the particular X-ray beam. Our study demonstrated the general usability of thimble ionization chambers. These thimble ionization chambers showed a maximum variation in energy response of 5%. Ionization chambers with even smaller sensitive volume, and which exhibit similar variation in energy dependence, can be used if higher spatial resolution is required. Furthermore, the investigated detectors are better suited for dosimetry at CT and CBCT units than conventional large volume or flat detectors, due to their rotational symmetry. Nevertheless, a flat detector can be used for certain measurement tasks, such as the acquisition of percent depth-dose curves or beam profiles for nonrotating beams, which are important for beam characterization.
| S-EPMC5690150 | biostudies-literature
Project description:We have compared synovial biopsies from ankylosing spondylitis and undifferentiated spondylitis patients with healthy controls and osteoarthritis patients Objective: In spondylarthropies, whole-genome gene expression profiling studies have been limited to peripheral blood to date. By undertaking a study in knee synovial biopsies from spondylarthropy (SpA) and ankylosing spondylitis (AS) patients we aimed to identified joint-specific candidate genes and pathways. These pathways may mediate systemic inflammation driven joint damaging processes and more specifically, the osteoproliferation that is characteristic of these conditions. Methods: RNA was extracted from six seronegative SpA, two AS, three osteoarthritis (OA) and four normal control knee synovial biopsies. Whole genome expression profiling was undertaken using the Illumina DASL system, which assays 24000 cDNA probes. Differentially expressed candidate genes were then validated using quantitative PCR and immunohistochemistry. Results: 416 differentially expressed genes were identified that clearly delineated between AS/SpA and control groups. Pathway analysis showed altered gene-expression in oxidoreductase activity, osteoblast activity, B-cell associated, matrix catabolic, and metabolic pathways. The inflammatory mediator, MMP3, was strongly upregulated in AS/SpA samples and the Wnt pathway inhibitors DKK3 and Kremen1 were downregulated. Conclusion: Pathways mediating both systemic inflammation as well as local tissue changes were identified. This suggests initial systemic inflammation in spondylarthropies transfers to and persists in the local joint environment, subsequently mediating changes in genes directly involved in the destructive tissue remodelling. Fifteen knee synovial biopsy tissue samples consisting of six seronegative spondyloarthropy (SpA), two ankylosing spondylitis (AS), three osteoarthritis (OA) and four normal control biopsies were obtained from the Synovial Tissue Bank at the Repatriation General Hospital in Adelaide, South Australia with the appropriate ethical approval (Supplementary Table 1). All patients provided informed written consent.
2012-12-01 | E-GEOD-41038 | biostudies-arrayexpress
Project description:BackgroundAnkylosing spondylitis (AS) is a chronic rheumatic disease that predominantly affects the axial skeleton, causing pain and functional impairment. Kinesiophobia, or fear of movement, is common in patients with chronic pain conditions and can significantly hinder treatment outcomes. This study aims to assess the level of kinesiophobia in AS patients and explore its relationship with demographic characteristics, disease duration, pain intensity, disease activity, and functional impairment.MethodsThis single-center study included 35 AS patients from July 2021 to July 2023. Patient demographics, disease duration, disease activity (BASDAI (Bath Ankylosing Spondylitis Disease Activity Index)), functionality (BASFI (Bath Ankylosing Spondylitis Functional Index)), pain intensity (VAS (Visual Analog Scale)), and kinesiophobia (TSK (Tampa Scale of Kinesiophobia)) were recorded and analyzed. Patients were categorized into low and high kinesiophobia groups based on TSK scores.ResultsOf the 35 AS patients, 15 (42.86%) had high kinesiophobia levels (TSK ≥37). Patients with high kinesiophobia had significantly higher BASDAI, BASFI, and VAS scores (p < 0.001) compared to those with low kinesiophobia. No significant relationship was found between kinesiophobia and age, gender, or disease duration (p > 0.05).ConclusionHigh levels of kinesiophobia in AS patients are associated with increased pain, disease activity, and functional impairment. Early interventions targeting kinesiophobia could improve treatment outcomes and patient functionality.
| S-EPMC11830361 | biostudies-literature