Age factor and concomitant pathologies in patients with sacroiliitis

Abstract

Introduction: Sacroiliitis is an inflammatory process which involves the sacroiliac joint, which is one of the diagnostic criteria for seronegative spondyloarthropathies. The objective of this study was to find correlations between New York radiographic criteria according to age and the concomitant pathologies in severe cases. Materials and methods: we used the medical records of 50 patients with different types of seronegative spondyloarthropaties: 20 men and 30 women.

Discussion results: The radiological evaluation of sacroiliitis was made according to the New York criteria which contain 5 degrees of evolution: 0 – normal; I – suspect, although unclear alterations; II – minimal erosions and sclerosis, but without joint space alteration; III – erosions and sclerosis, with widening or narrowing of the joint space; IV – ankylosis. In 50% of men ankylosing spondylitis was present and 77% of women had psoriatic arthritis. Between the ages 20-29 more women were found with IInd degree sacroiliac joint damage. In the 30-39 range there were also only women with IInd degree damage. In the 40-49 range more men were found with IVth degree damage. In other age groups no specific incidence was found. All sever degrees (III-IV) in men- 10 patients with ages between 40- 69, with ankylosing spondylitis were more likely to have concomitant pathologies like HVB, autoimmune thyroiditis and arthrosis. In women, 3 patients between 50-69 years, radiological degrees III-IV of sacroiliitis were associated with postmenopausal osteoporosis, HVB and arthrosis. Thus, we see that in severe cases of sacroiliitis there is presence of HVB. The relation is confirmed in some studies that demonstrate the role of HVB and HCV viruses in the etiology of autoimmune diseases. On the other hand, immunosuppressive drugs are commonly used in the management of rheumatic diseases and were shown to induce viral reactivation in HVB- and HCVpositive patients.

Conclussion: Studies show that there are no significant radiological changes of the sacroiliac joint in young adult pacients with seronegative spondyloartropathies. Severe sacroiliitis is more specific for old and middle aged men, diagnosed with this condition. In cases of severe sacroileitis, HVB and arthrosis have been detected as concomitant illnesses in both men and women.

Key words: seronegative spondyloarthropaties, radiologic criteria, sacroiliitis, HVB.