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Prevalence of axial spondyloarthropathy among patients suffering from Fibromyalgia - an MRI study with application of the ASAS classification criteria

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Ablin JN, Eshed I, Berman M, Aloush V, Wigler I, Caspi D, Likhter M, Wollman J, Paran D, Anouk M, Elkayam O. Prevalence of axial spondyloarthropathy among patients suffering from Fibromyalgia - an MRI study with application of the ASAS classification criteria. Arthritis Care Res (Hoboken). 2016 Jul. PubMed #27390225.
Tags: diagnosis, fibromyalgia, arthritis, inflammation, chronic pain, pain problems, aging

original abstract

OBJECTIVE: To evaluate the prevalence of sacroiliitis, the radiographic hallmark of inflammatory spondyloarthropathy, among patients diagnosed with the fibromyalgia syndrome, using the current ASAS criteria and MR imaging.

METHODS: Patients suffering from FMS (ACR 1990 criteria) were interviewed regarding presence of SpA features and underwent HLA-B27 testing, CRP measurement and MRI examinations of the sacro-iliac joints. FMS severity was assessed by the FIQ and SF-36 questionnaires. SpA severity was assessed by the BASDAI.

RESULTS: Sacroiliitis was demonstrated among 8 (8.1%) of patients and ASAS criteria for diagnosis of axial SpA were met in 10 (10.2%) of patients. Imaging changes suggestive of inflammatory involvement (e.g. erosions and sub-chondreal sclerosis) were demonstrated in 15 (17%) and 22 (25%) of patients respectively. The diagnosis of axial SpA was positively correlated with increased CRP and with physical role limitation at recruitment.

CONCLUSION: Imaging changes suggestive of axial SpA were common among patients presenting with a diagnosis of FMS. These findings suggest that FMS may mask an underlying axial SpA, a diagnosis with important therapeutic implications. Physicians involved in the management of FMS should remain vigilant to the possibility of underlying inflammatory disorders and actively search for such co-morbidities.

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