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7. Prevalence of undiagnosed axial spondyloarthritis in inflammatory bowel disease patients with chronic back pain: secondary care cross-sectional study.

Author

Lim, Chong Seng Edwin, Tremelling, Mark, Hamilton, Louise, Kim, Matthew, Macgregor, Alexander, Turmezei, Tom, and Gaffney, Karl

Subjects
PELVIC radiography, LUMBAR pain, CHRONIC pain, PHYSICAL diagnosis, C-reactive protein, INFLAMMATORY bowel diseases, ACADEMIC medical centers, CONFIDENCE intervals, ANKYLOSIS, ACQUISITION of data, HEALTH outcome assessment, MAGNETIC resonance imaging, SPONDYLOARTHROPATHIES, QUESTIONNAIRES, MEDICAL records, DESCRIPTIVE statistics, DISEASE duration, MEDICAL needs assessment, ANTIGENS, DISEASE complications
Abstract

Objective To elucidate the prevalence of undiagnosed rheumatology-verified diagnosis of axial spondyloarthritis (RVD-axSpA) in patients attending routine secondary care IBD clinics with chronic back pain. Methods Screening questionnaires were sent to consecutive patients attending IBD clinics in a university teaching hospital. Patients fulling the eligibility criteria (gastroenterologist-verified diagnosis, 18–80 years old, biologic therapy naive, no previous diagnosis of axSpA); and a moderate diagnostic probability of axSpA [self-reported chronic back pain (CBP) >3 months, onset <45 years] were invited for rheumatology assessment. This included medical review, physical examination, patient reported outcome measures, human leucocyte antigen B27, C-reactive protein, pelvic radiograph and axSpA protocol magnetic resonance imaging. A diagnosis of RVD-axSpA was made by a panel of rheumatologists. Results Of the 470 patients approached, 91 had self-reported CBP >3 months, onset <45 years, of whom 82 were eligible for clinical assessment. The prevalence of undiagnosed RVD-axSpA in patients attending IBD clinics in a secondary care setting, with self-reported CBP, onset <45 years is estimated at 5% (95% CI 1.3, 12.0) with a mean symptom duration of 12 (s. d. 12.4) years. Conclusion There is a significant hidden disease burden of axSpA among IBD patients. Appropriate identification and referral from gastroenterology is needed to potentially shorten the delay to diagnosis and allow access to appropriate therapy. [ABSTRACT FROM AUTHOR]

Published
2023
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13. Acknowledgments

Author

Herring, John A., primary, Daniel, Cindy Godwin, additional, Hamilton, Louise Nunes, additional, Cuesta, Phyllis, additional, Almond, Stuart, additional, Tune, Lilla, additional, Bucholz, Emily, additional, Tune, Sarah, additional, Jolly, Paul, additional, Carduff, Alexander, additional, Taylor, Margaret, additional, and Peters, Mary, additional

Published
2008
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17. Cross‐cultural adaptation of the Hamilton axial spondyloarthritis questionnaire and development of a Chinese version in a multi‐ethnic Asian population

Author

Xiang, Ling, primary, Teo, Edmund Pek Siang, additional, Low, Andrea Hsiu Ling, additional, Leung, Ying Ying, additional, Fong, Warren, additional, Xin, Xiaohui, additional, Gandhi, Mihir, additional, Kwan, Yu Heng, additional, Uy, Elenore J. B., additional, Hamilton, Louise, additional, and Thumboo, Julian, additional

Published
2019
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18. Influencer marketing - En studie om hur den svenska marknadsföringsrätten förhåller sig till marknadsföring av influencers på sociala medier

Author

Hamilton, Louise and Hamilton, Louise

Abstract

As technology moves forward, marketing methods follow and influencer marketing is the most prominent one today, being a rather unexplored part of marketing, lacking clear legislation. Hence, companies use influencers and their platforms to advertise their products and services leading to a line of business where the legal aspect is obscure. The purpose of this essay is to investigate and illuminate the problems which come as a consequence of influencer marketing, to what level the marketing act (MFL) is applicable on social media, which requirements that apply to social media marketing, which parties should be held responsible of the unwarranted marketing and their relationship to each other. Therefore, the main conclusion is that the difference between commercial advertising and editorial content on social media seems hard to recognize. For some difficult cases, the fundamental law on freedom of expression is deemed to precede the marketing act despite advertising identification and transmitting indication being significantly higher for influencer marketing compared to traditional marketing strategies. Furthermore, the style of the commercial post needs to differentiate from the countering editorial post. Thus, the consumer needs to instantly be able to understand if the post is actually advertising. Subsequently, if a company pays an influencer or sends an influencer free goods this is legally regarded as a degree of payment for the publicity and marketing the influencer provides due to an underlying agreement between the influencer and the company. Therefore, the extent to which one party can be held accountable depends on their influence on the final outcome of the commercial post., Influencer marketing är ett relativt outforskat område vars regleringar ännu inte är helt klarlagda. På grund av den snabba digitala teknikutvecklingen har marknadsföring på sociala medier blivit en avgörande marknadsföringsmetod. Företag använder sig i stor utsträckning av influencers och deras plattformar för att marknadsföra sig och sina produkter eller tjänster. Detta har lett till en bransch med mycket oklarheter vad gäller de rättsliga aspekterna. Syftet med uppsatsen är att utreda och klargöra de problem som uppstår vid influencer marketing, i vilken grad MFL är tillämplig på sociala medier, vilka krav som gäller när det kommer till marknadsföring på sociala medier och vilka parter som kan bli inblandade samt deras förhållande till varandra. Det går att konstatera, efter analys, att gränsdragningen mellan kommersiellt och icke kommersiellt material på sociala medier är svårdragen. Enligt svensk rätt har yttrandefrihetsgrundlagen företräde framför MFL när det gäller blandade meddelanden på sociala medier. Det har även framgått att kravet på reklamidentifiering och sändarangivelse är betydligt högre vid influencer marketing då kommersiella inlägg ska, i sin utformning, tydligt skilja sig från redaktionella inlägg och konsumenten ska, även vid flyktig kontakt, förstå att det är ett reklaminlägg. Slutligen har det framgått att i den stund det utgår ersättning av någon form till influencern och influencern skriver om företaget och dess produkter eller tjänster är det fråga om marknadsföring och ett slags underliggande avtal föreligger mellan parterna. Vem som blir huvudansvarig och medverkanansvarig vid den ansvarsfördelning som uppstår beror på de olika parternas inverkan på den slutliga utformningen av det kommersiella inlägget.

Published
2019

19. Spondylarthropathies (including psoriatic arthritis): 244. Validity of Colour Doppler and Spectral Doppler Ultrasound of Sacroilicac Joints Againts Physical Examination as Gold Standard

Author

Castillo-Gallego, Concepcion, de Miguel Mendieta, Eugenio, Garcia-Arias, Miriam, Plasencia-Rodriguez, Chamaida, Lojo-Oliveira, Leticia, Martin-Mola, Emilio, Tillett, William, Cavill, Charlotte, Korendowych, Ellie, McHugh, Neil, Coates, Lucy, Bhalla, Ashok K., Creamer, Paul, Packham, Jon, Hailwood, Sarah, Taylor, Gordon, Hamilton, Louise, Brooksby, Alan, Leeder, Jane, Gaffney, Karl, Malipeddi, Aruna S., Neame, Rebecca, Francis, James, Hassan, Waji, Mease, Philip, Olds, Michele, Kary, Sonja, Kupper, Hartmut, Bell, Carolyn, Peffers, Gill, Rees, Frances, Lanyon, Peter, Obrenovic, Karen, Sandhu, Ravinder, Packham, Jonathan, Erb, Nicola, Coates, Laura C., Conaghan, Philip, Emery, Paul, Green, Michael, Ibrahim, Gamal, MakIver, Helen, Helliwell, Philip, Giles, Joanna L., McHugh, Kirsty, DiGleria, Katilin, Shaw, Jackie, Kollnberger, Simon, Maenaka, Katsumi, Marroquin, Osiris, Renner, Christoph, Bowness, Paul, Landewe, Robert, Ritchlin, Christopher, Guérette, Benoit, Lavie, Frederic, Kavanaugh, A., McInnes, I., Krueger, G. G., Gladman, D., Zrubek, J., Goldstein, N., Xu, S., Mudivarthy, S., Mack, M., Prevosto, Claudia, McDonald, Sarah, De Riva, Alessandra, Goodman, Reyna, Key, Tim, Hill Gaston, J S., Deery, Michael J., Busch, Robert, Fischer, Roman, Wright, Cynthia, Kessler, Benedikt, Sheehy, Claire, Jois, Ramesh N., Kerrigan, Nicola, Mills, Karen S., Somerville, Margaret, Scott, David G., van der Heijde, D., Chattopadhyay, Chandra, Mease, P., Xu, W., Rahman, M. U., Baratelle, A., Beutler, A., Stober, Carmel B., Benham, Helen J., Goodall, Jane C., Hill Gaston, J.S., Sanyal, Kaushik, Walker-Bone, Karen, Helliwell, Philip S., Vastesaeger, N., Wang, Y., Inman, R., Deodhar, A., Hsu, B., Dijkmans, B., Braun, J., Geusens, P., Sieper, J., El Miedany, Yasser, Palmer, Deborah, Shaw, Jacqueline, Payeli, Sravan, Utriainen, Lotta, and Milling, Simon

Subjects
musculoskeletal diseases
Abstract

Background: Sacroiliac joints (SJ) involvement is a distinctive and charasteristic feature of Spondyloarthritis (SpA) and x-ray is the test routinely used to make a diagnosis. However, x-ray reveals late structural damage but cannot detect active inflammation. The objective of this study was to assess the validity of Doppler ultrasound in SJ. Methods: Prospective blinded and controlled study of SJ, in which three populations were compared. We studied 106 consecutive cases, who were divided into three groups: a) 53 patients diagnosed with SpA who had inflammatory lumbar and gluteal pain assessed by a rheumatologist; b) 26 patients diagnosed with SpA who didn't have SJ tenderness and had normal physical examination; c) control group of 27 subjects (healthy subjetcs or with mechanical lumbar pain). All patients included that were diagnosed with SpA met almost the European Spondyloarthropathy Study Group (ESSG) classification criteria. Physical examination of the SJ included: sacral sulcus tenderness, iliac gapping, iliac compression, midline sacral thrust test, Gaenslen's test, and Patrick s test were used as gold standard. Both SJ were examined with Doppler ultrasound (General Electric Logiq 9, Wauwatosa WI, USA) fitted with a 9-14 Mhz lineal probe. The ultrasonographer was blinded to clinical data. Doppler in SJ was assessed as positive when both Doppler colour and resistance index (RI)

Published
2017

20. Total quality management: Strengths and barriers to implementation and cultural adaptation

Author

Siegfeldt, Denise V, Glenn, Michael, and Hamilton, Louise

Subjects
Quality Assurance And Reliability
Abstract

NASA/Langley Research Center (LaRC) is in the process of implementing Total Quality Management (TQM) throughout the organization in order to improve productivity and make the Center an even better place to work. The purpose of this project was to determine strengths and barriers to TQM being implemented and becoming a part of the organizational culture of the Human Resources Management Division (HRMD) at Langley. The target population for this project was both supervisory and nonsupervisory staff of the HMRD. In order to generate data on strengths and barriers to TQM implementation and cultural adaptation, a modified nominal group technique was used.

Published
1992

23. The 'Unidentified Patient' in Home Health Care.

Author

Hamilton, Louise A. and Jones, Helen Carol

Abstract

Aging individuals are most often cared for by a spouse or middle-aged child, usually a daughter. As the aging population increases, as longevity increases along with the likelihood of chronic and disabling conditions, women will be facing many special problems related to their role as caregiver. Many women who are serving as caregivers to their ailing husbands or other family members are also suffering from a chronic disease or disability themselves. These women are the "unidentified patients" in home health care, caregivers who have chronic conditions themselves and are patients in their own right, though functioning at a higher level of autonomy and independence than the identified patient. How caregivers feel about the caregiver role often depends upon the way in which the caregiving responsibility has been assigned to them, their expectations regarding the responsibility, and expectations of others regarding the role. Quite often there is a crisis in which the role is assumed quickly without the luxury of time to review the role. Families are often unprepared for the 24-hour responsibility and restrictions of caregiving. Continuous or nighttime supervision is perceived as one of the most difficult services for families to provide. Caregivers have a threshold beyond which it is difficult for them to increase their supportive services. There is a need for a mechanism to raise the status of caregiving while at the same time focusing some care, attention, and concern to the caregiver as well as to the patient. (NB)

Published
1986

24. Physician Self-referrals: Select Analyses of Trends and Issues

Author

Hamilton, Louise and Hamilton, Louise

Subjects
Medical referral, Medicine--Practice
Abstract

Self-referral occurs when a provider refers patients to entities in which the provider or the provider's family members have a financial interest. Rising Medicare expenditures for PT services have long been of concern, and questions have been raised about the role of self-referral in this growth. This book examines trends in the number of and expenditures for self-referred and non-self-referred Medicare PT services and how provision of these services differs among providers on the basis of whether they self-refer. It also discusses similar trends in cancer treatments, anatomic pathology services, and advanced imaging services.

Published
2015

26. Comment on: Tumour necrosis factor inhibitor survival and predictors of response in axial spondyloarthritis—findings from a United Kingdom cohort: reply

Author

Yahya, Fariz, primary, Gaffney, Karl, additional, Hamilton, Louise, additional, Lonsdale, Ellie, additional, Leeder, Jane, additional, Brooksby, Alan, additional, Cavill, Charlotte, additional, Berry-Jenkins, Joshua, additional, Boyle, Cathal, additional, Bond, Debbie, additional, and Sengupta, Raj, additional

Published
2018
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29. Oral abstracts 1: SpondyloarthropathiesO1. Detecting axial spondyloarthritis amongst primary care back pain referrals

Author

Harris, Claire, Remedios, Denis, Aptowitzer, Tanya, Keat, Andrew, Hamilton, Louise, Guile, Geoffrey, Belkhiri, Abdelghani, Newman, David, Toms, Andoni, Macgregor, Alex, Gaffney, Karl, Morton, Linda, Jones, Gareth T., MacDonald, Alan G., Downham, Christina, Macfarlane, Gary J., Tillett, William, Jadon, Deepak, Wallis, Dinny, Costa, Luisa, Waldron, Nicola, Griffith, Nina, Cavill, Charlotte, Korendowych, Eleanor, de Vries, Corinne, McHugh, Neil, Iaremenko, Oleg, Fedkov, Dmytro, Emery, Paul, Baeten, Dominique, Sieper, Joachim, Braun, Jurgen, van der Heijde, D., McInnes, Iain, Van Laar, Jaap, Landewe, R., Wordsworth, Bryan P., Wollenhaupt, Jurgen, Kellner, Herbert, Paramarta, I., Bertolino, Arthur, Wright, Andrew M., Hueber, Wolfgang, Sofat, Nidhi, Smee, Cori, Hermansson, Monika, Wajed, Julekha, Sanyal, Kaushik, Kiely, Patrick, Howard, Matthew, Howe, Franklyn A., Barrick, Thomas R., Abraham, Ajay M., Pearce, Mark S., Mann, Kay D., Francis, Roger M., Birrell, Fraser, Carr, Andrew, Macleod, Iain, Ng, Wan-Fai, Kavanaugh, Arthur, van der Heijde, Desiree, Chattopadhyay, Chandrabhusan, Gladman, Dafna, Mease, Philip, Krueger, Gerald, Xu, Weichun, Goldstein, Neil, Beutler, Anna, Baraliakos, Xenofon, Laurent, Didier D., Wollenhaupt, Jürgen, Gsteiger, Sandro, Conaghan, Philip G., Peterfy, Charles G., DiCarlo, Julie, Olech, Ewa, Alberts, Alan R., Alper, Jeffrey A., Devenport, Jenny, Anisfeld, Andrew M., Troum, Orrin M., Cooper, Philip, Gimpel, Mo, Deakin, Greg, Jameson, Karen, Godtschailk, Malcolm, Gadola, Stephan, Stokes, Maria, Cooper, Cyrus, Gordon, Caroline, Kalunian, K., Petri, M., Strand, V., Kilgallen, B., Barry, A., Wallace, D., Flurey, Caroline A., Morris, Marianne, Pollock, Jon, Hughes, Rod, Richards, Pam, Hewlett, Sarah, Harris, Claire, Remedios, Denis, Aptowitzer, Tanya, Keat, Andrew, Hamilton, Louise, Guile, Geoffrey, Belkhiri, Abdelghani, Newman, David, Toms, Andoni, Macgregor, Alex, Gaffney, Karl, Morton, Linda, Jones, Gareth T., MacDonald, Alan G., Downham, Christina, Macfarlane, Gary J., Tillett, William, Jadon, Deepak, Wallis, Dinny, Costa, Luisa, Waldron, Nicola, Griffith, Nina, Cavill, Charlotte, Korendowych, Eleanor, de Vries, Corinne, McHugh, Neil, Iaremenko, Oleg, Fedkov, Dmytro, Emery, Paul, Baeten, Dominique, Sieper, Joachim, Braun, Jurgen, van der Heijde, D., McInnes, Iain, Van Laar, Jaap, Landewe, R., Wordsworth, Bryan P., Wollenhaupt, Jurgen, Kellner, Herbert, Paramarta, I., Bertolino, Arthur, Wright, Andrew M., Hueber, Wolfgang, Sofat, Nidhi, Smee, Cori, Hermansson, Monika, Wajed, Julekha, Sanyal, Kaushik, Kiely, Patrick, Howard, Matthew, Howe, Franklyn A., Barrick, Thomas R., Abraham, Ajay M., Pearce, Mark S., Mann, Kay D., Francis, Roger M., Birrell, Fraser, Carr, Andrew, Macleod, Iain, Ng, Wan-Fai, Kavanaugh, Arthur, van der Heijde, Desiree, Chattopadhyay, Chandrabhusan, Gladman, Dafna, Mease, Philip, Krueger, Gerald, Xu, Weichun, Goldstein, Neil, Beutler, Anna, Baraliakos, Xenofon, Laurent, Didier D., Wollenhaupt, Jürgen, Gsteiger, Sandro, Conaghan, Philip G., Peterfy, Charles G., DiCarlo, Julie, Olech, Ewa, Alberts, Alan R., Alper, Jeffrey A., Devenport, Jenny, Anisfeld, Andrew M., Troum, Orrin M., Cooper, Philip, Gimpel, Mo, Deakin, Greg, Jameson, Karen, Godtschailk, Malcolm, Gadola, Stephan, Stokes, Maria, Cooper, Cyrus, Gordon, Caroline, Kalunian, K., Petri, M., Strand, V., Kilgallen, B., Barry, A., Wallace, D., Flurey, Caroline A., Morris, Marianne, Pollock, Jon, Hughes, Rod, Richards, Pam, and Hewlett, Sarah

Abstract

Background: Inflammatory back pain (IBP) is an early feature of ankylosing spondylitis (AS) and its detection offers the prospect of early diagnosis of AS. However, since back pain is very common but only a very small minority of back pain sufferers have ASpA or AS, screening of back pain sufferers for AS is problematic. In early disease radiographs are often normal so that fulfilment of diagnostic criteria for AS is impossible though a diagnosis of axial SpA can be made if MRI evidence of sacroiliitis is present. This pilot study was designed to indicate whether a cost-effective pick up rate for ASpA/early AS could be achieved by identifying adults with IBP stratified on the basis of age. Methods: Patients aged between 18 and 45 years who were referred to a hospital physiotherapy service with back pain of more than 3 months duration were assessed for IBP. All were asked to complete a questionnaire based on the Berlin IBP criteria. Those who fulfilled IBP criteria were also asked to complete a second short questionnaire enquiring about SpA comorbidities, to have a blood test for HLA-B27 and CRP level and to undergo an MRI scan of the sacroiliac joints. This was a limited scan, using STIR, diffusion-weighted, T1 and T2 sequences of the sacroiliac joints to minimize time in the scanner and cost. The study was funded by a research grant from Abbott Laboratories Ltd. Results: 50 sequential patients agreed to participate in the study and completed the IBP questionnaire. Of these 27 (54%) fulfilled criteria for IBP. Of these, 2 patients reported a history of an SpA comorbidity - 1 psoriasis; 1 ulcerative colitis - and 3 reported a family history of an SpA comorbidity - 2 psoriasis; 1 Crohn's disease. 4 were HLA-B27 positive, though results were not available for 7. Two patients had marginally raised CRP levels (6, 10 -NR ≤ 5). 19 agreed to undergo MRI scanning of the sacroiliac joints and lumbar spine; 4 scans were abnormal, showing evidence of bilateral sacroiliitis on S

Published
2017

30. BSR and BHPR guideline for the treatment of axial spondyloarthritis (including ankylosing spondylitis) with biologics

Author

Hamilton, Louise, primary, Barkham, Nick, additional, Bhalla, Ashok, additional, Brittain, Robin, additional, Cook, Debbie, additional, Jones, Gareth, additional, Mackay, Kirsten, additional, Marshall, David, additional, Marzo-Ortega, Helena, additional, Murphy, Daniel, additional, Riddell, Claire, additional, Sengupta, Raj, additional, Siebert, Stefan, additional, Van Rossen, Liz, additional, and Gaffney, Karl, additional

Published
2016
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32. Tumour necrosis factor inhibitor survival and predictors of response in axial spondyloarthritis--findings from a United Kingdom cohort.

Author

Yahya, Fariz, Gaffney, Karl, Hamilton, Louise, Lonsdale, Ellie, Leeder, Jane, Brooksby, Alan, Cavill, Charlotte, Berry-Jenkins, Joshua, Boyle, Cathal, and Bond, Debbie

Subjects
ANTIRHEUMATIC agents, TREATMENT effectiveness, FORECASTING, ANKYLOSING spondylitis, CONFIDENCE intervals, LONGITUDINAL method, PROBABILITY theory, SMOKING, TUMOR necrosis factors, DISEASE remission, RETROSPECTIVE studies, DESCRIPTIVE statistics, CHEMICAL inhibitors
Abstract

Objectives. To analyse long-term survival and efficacy of TNFi, reasons for switching or discontinuing, baseline predictors of response and remission in axial spondyloarthritis (axSpA) patients in a UK cohort. Methods. All patients with a physician-verified diagnosis of axSpA attending two specialist centres who fulfilled the eligibility criteria for TNFi were included. Routinely recorded patient data were reviewed retrospectively. Initial TNFi was recorded as the index drug. Results. Six hundred and fifty-one patients (94% AS) were included; adalimumab (n = 332), etanercept (n = 205), infliximab (n = 51), golimumab (n = 40) and certolizumab pegol (n = 23) were index TNFi. The mean (S.D.) duration from symptom onset to time of diagnosis was 8.6 (8.7) years and mean (S.D.) duration from diagnosis to TNFi initiation was 12.6 (11.5) years. A total of 224 (34.4%) stopped index TNFi, and 105/224 switched to a second TNFi. Median drug survival for index and second TNFi were 10.2 years (95% CI: 8.8, 11.6 years) and 5.5 years (95% CI: 2.7, 8.3 years), respectively (P < 0.05). Survival rates were not influenced by choice of TNFi. HLA-B27 predicted BASDAI50 and/or two or more point reduction within 6 months and long-term drug survival (P < 0.05). Low disease activity was predicted by non-smoking and low baseline BASDAI (P < 0.05). Conclusion. We have observed good TNFi survival rates in axSpA patients treated in a real-life setting. This is best for first TNFi and not influenced by drug choice. [ABSTRACT FROM AUTHOR]

Published
2018
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34. LETTERS.

Author

COOPER, ROBERT M., HAMILTON, LOUISE F., BENOIT, LARRY G., SCHWEIER, A., BRYAN, FRANK, MCDONALD, LEE C., ZIMBELMAN, C. R., HEARN, G. A., OGDEN, MARY B., FITZGERALD, GERALD, FIOCK FILDES, JOHNSIE M., ARTHUR, FRANCIS, BIAS, RANDOLPH, DAVIS, HUGH W., MUNROE, GEORGE B., WORCESTER, ANN ATWOOD, and FOSSUM, PAUL R.

Subjects
LETTERS to the editor, BOYLE'S law, SANDPAINTINGS, PRESIDENTIAL candidates
Abstract

Several letters to the editor are presented in response to topics in previous issues including Boyle's law, sand painting and U.S. presidential candidate Dwight D. Eisenhower.

Published
1951

44. Obituary

Author

Hamilton, Louise W.

Published
2004

47. Acknowledgments

Author

Herring, John A., Daniel, Cindy Godwin, Hamilton, Louise Nunes, Cuesta, Phyllis, Almond, Stuart, Tune, Lilla, Tune, Sarah, Carduff, Alexander, Jolly, Paul, and Taylor, Margaret

Published
2014
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48. Ellen Key : een levensschets

Author

Universiteitsbibliotheek Utrecht, Nyström-Hamilton, Louise, Universiteitsbibliotheek Utrecht, and Nyström-Hamilton, Louise

Published
1905

49. Spondylarthropathies (including psoriatic arthritis): 244. Validity of Colour Doppler and Spectral Doppler Ultrasound of Sacroilicac Joints Againts Physical Examination as Gold Standard

Author

Castillo-Gallego, Concepcion, de Miguel Mendieta, Eugenio, Garcia-Arias, Miriam, Plasencia-Rodriguez, Chamaida, Lojo-Oliveira, Leticia, Martin-Mola, Emilio, Tillett, William, Cavill, Charlotte, Korendowych, Ellie, McHugh, Neil, Coates, Lucy, Bhalla, Ashok K., Creamer, Paul, Packham, Jon, Hailwood, Sarah, Taylor, Gordon, Hamilton, Louise, Brooksby, Alan, Leeder, Jane, Gaffney, Karl, Malipeddi, Aruna S., Neame, Rebecca, Francis, James, Hassan, Waji, Mease, Philip, Olds, Michele, Kary, Sonja, Kupper, Hartmut, Bell, Carolyn, Peffers, Gill, Rees, Frances, Lanyon, Peter, Obrenovic, Karen, Sandhu, Ravinder, Packham, Jonathan, Erb, Nicola, Coates, Laura C., Conaghan, Philip, Emery, Paul, Green, Michael, Ibrahim, Gamal, MakIver, Helen, Helliwell, Philip, Giles, Joanna L., McHugh, Kirsty, DiGleria, Katilin, Shaw, Jackie, Kollnberger, Simon, Maenaka, Katsumi, Marroquin, Osiris, Renner, Christoph, Bowness, Paul, Landewe, Robert, Ritchlin, Christopher, Guérette, Benoit, Lavie, Frederic, Kavanaugh, A., McInnes, I., Krueger, G. G., Gladman, D., Zrubek, J., Goldstein, N., Xu, S., Mudivarthy, S., Mack, M., Prevosto, Claudia, McDonald, Sarah, De Riva, Alessandra, Goodman, Reyna, Key, Tim, Hill Gaston, J S., Deery, Michael J., Busch, Robert, Fischer, Roman, Wright, Cynthia, Kessler, Benedikt, Sheehy, Claire, Jois, Ramesh N., Kerrigan, Nicola, Mills, Karen S., Somerville, Margaret, Scott, David G., van der Heijde, D., Chattopadhyay, Chandra, Mease, P., Xu, W., Rahman, M. U., Baratelle, A., Beutler, A., Stober, Carmel B., Benham, Helen J., Goodall, Jane C., Hill Gaston, J.S., Sanyal, Kaushik, Walker-Bone, Karen, Helliwell, Philip S., Vastesaeger, N., Wang, Y., Inman, R., Deodhar, A., Hsu, B., Dijkmans, B., Braun, J., Geusens, P., Sieper, J., El Miedany, Yasser, Palmer, Deborah, Shaw, Jacqueline, Payeli, Sravan, Utriainen, Lotta, Milling, Simon, Castillo-Gallego, Concepcion, de Miguel Mendieta, Eugenio, Garcia-Arias, Miriam, Plasencia-Rodriguez, Chamaida, Lojo-Oliveira, Leticia, Martin-Mola, Emilio, Tillett, William, Cavill, Charlotte, Korendowych, Ellie, McHugh, Neil, Coates, Lucy, Bhalla, Ashok K., Creamer, Paul, Packham, Jon, Hailwood, Sarah, Taylor, Gordon, Hamilton, Louise, Brooksby, Alan, Leeder, Jane, Gaffney, Karl, Malipeddi, Aruna S., Neame, Rebecca, Francis, James, Hassan, Waji, Mease, Philip, Olds, Michele, Kary, Sonja, Kupper, Hartmut, Bell, Carolyn, Peffers, Gill, Rees, Frances, Lanyon, Peter, Obrenovic, Karen, Sandhu, Ravinder, Packham, Jonathan, Erb, Nicola, Coates, Laura C., Conaghan, Philip, Emery, Paul, Green, Michael, Ibrahim, Gamal, MakIver, Helen, Helliwell, Philip, Giles, Joanna L., McHugh, Kirsty, DiGleria, Katilin, Shaw, Jackie, Kollnberger, Simon, Maenaka, Katsumi, Marroquin, Osiris, Renner, Christoph, Bowness, Paul, Landewe, Robert, Ritchlin, Christopher, Guérette, Benoit, Lavie, Frederic, Kavanaugh, A., McInnes, I., Krueger, G. G., Gladman, D., Zrubek, J., Goldstein, N., Xu, S., Mudivarthy, S., Mack, M., Prevosto, Claudia, McDonald, Sarah, De Riva, Alessandra, Goodman, Reyna, Key, Tim, Hill Gaston, J S., Deery, Michael J., Busch, Robert, Fischer, Roman, Wright, Cynthia, Kessler, Benedikt, Sheehy, Claire, Jois, Ramesh N., Kerrigan, Nicola, Mills, Karen S., Somerville, Margaret, Scott, David G., van der Heijde, D., Chattopadhyay, Chandra, Mease, P., Xu, W., Rahman, M. U., Baratelle, A., Beutler, A., Stober, Carmel B., Benham, Helen J., Goodall, Jane C., Hill Gaston, J.S., Sanyal, Kaushik, Walker-Bone, Karen, Helliwell, Philip S., Vastesaeger, N., Wang, Y., Inman, R., Deodhar, A., Hsu, B., Dijkmans, B., Braun, J., Geusens, P., Sieper, J., El Miedany, Yasser, Palmer, Deborah, Shaw, Jacqueline, Payeli, Sravan, Utriainen, Lotta, and Milling, Simon

Abstract

Background: Sacroiliac joints (SJ) involvement is a distinctive and charasteristic feature of Spondyloarthritis (SpA) and x-ray is the test routinely used to make a diagnosis. However, x-ray reveals late structural damage but cannot detect active inflammation. The objective of this study was to assess the validity of Doppler ultrasound in SJ. Methods: Prospective blinded and controlled study of SJ, in which three populations were compared. We studied 106 consecutive cases, who were divided into three groups: a) 53 patients diagnosed with SpA who had inflammatory lumbar and gluteal pain assessed by a rheumatologist; b) 26 patients diagnosed with SpA who didn't have SJ tenderness and had normal physical examination; c) control group of 27 subjects (healthy subjetcs or with mechanical lumbar pain). All patients included that were diagnosed with SpA met almost the European Spondyloarthropathy Study Group (ESSG) classification criteria. Physical examination of the SJ included: sacral sulcus tenderness, iliac gapping, iliac compression, midline sacral thrust test, Gaenslen's test, and Patrick s test were used as gold standard. Both SJ were examined with Doppler ultrasound (General Electric Logiq 9, Wauwatosa WI, USA) fitted with a 9-14 Mhz lineal probe. The ultrasonographer was blinded to clinical data. Doppler in SJ was assessed as positive when both Doppler colour and resistance index (RI) < 0.75 within the SJ area were present. Statistical analysis was performed estimating sensitivity and specificity against gold standard. The Kappa correlation coefficient was used for reliability study. Results: 106 cases (53 female, 55 male; mean age 36 10 years) were studied. There were no statistical differences between groups related to age or sex. Physical examination of SJ was positive in 38 patients (59 sacroiliac joints). US detected Doppler signal within SJ in 37 patients (58 SJ): 33 of them were symptomatic SpA (52 SJ), one of them were asymptomatic SpA (1 SJ) and one was a

50. Oral abstracts 1: SpondyloarthropathiesO1. Detecting axial spondyloarthritis amongst primary care back pain referrals

Author

Harris, Claire, Remedios, Denis, Aptowitzer, Tanya, Keat, Andrew, Hamilton, Louise, Guile, Geoffrey, Belkhiri, Abdelghani, Newman, David, Toms, Andoni, Macgregor, Alex, Gaffney, Karl, Morton, Linda, Jones, Gareth T., MacDonald, Alan G., Downham, Christina, Macfarlane, Gary J., Tillett, William, Jadon, Deepak, Wallis, Dinny, Costa, Luisa, Waldron, Nicola, Griffith, Nina, Cavill, Charlotte, Korendowych, Eleanor, de Vries, Corinne, McHugh, Neil, Iaremenko, Oleg, Fedkov, Dmytro, Emery, Paul, Baeten, Dominique, Sieper, Joachim, Braun, Jurgen, van der Heijde, D., McInnes, Iain, Van Laar, Jaap, Landewe, R., Wordsworth, Bryan P., Wollenhaupt, Jurgen, Kellner, Herbert, Paramarta, I., Bertolino, Arthur, Wright, Andrew M., Hueber, Wolfgang, Sofat, Nidhi, Smee, Cori, Hermansson, Monika, Wajed, Julekha, Sanyal, Kaushik, Kiely, Patrick, Howard, Matthew, Howe, Franklyn A., Barrick, Thomas R., Abraham, Ajay M., Pearce, Mark S., Mann, Kay D., Francis, Roger M., Birrell, Fraser, Carr, Andrew, Macleod, Iain, Ng, Wan-Fai, Kavanaugh, Arthur, van der Heijde, Desiree, Chattopadhyay, Chandrabhusan, Gladman, Dafna, Mease, Philip, Krueger, Gerald, Xu, Weichun, Goldstein, Neil, Beutler, Anna, Baraliakos, Xenofon, Laurent, Didier D., Wollenhaupt, Jürgen, Gsteiger, Sandro, Conaghan, Philip G., Peterfy, Charles G., DiCarlo, Julie, Olech, Ewa, Alberts, Alan R., Alper, Jeffrey A., Devenport, Jenny, Anisfeld, Andrew M., Troum, Orrin M., Cooper, Philip, Gimpel, Mo, Deakin, Greg, Jameson, Karen, Godtschailk, Malcolm, Gadola, Stephan, Stokes, Maria, Cooper, Cyrus, Gordon, Caroline, Kalunian, K., Petri, M., Strand, V., Kilgallen, B., Barry, A., Wallace, D., Flurey, Caroline A., Morris, Marianne, Pollock, Jon, Hughes, Rod, Richards, Pam, Hewlett, Sarah, Harris, Claire, Remedios, Denis, Aptowitzer, Tanya, Keat, Andrew, Hamilton, Louise, Guile, Geoffrey, Belkhiri, Abdelghani, Newman, David, Toms, Andoni, Macgregor, Alex, Gaffney, Karl, Morton, Linda, Jones, Gareth T., MacDonald, Alan G., Downham, Christina, Macfarlane, Gary J., Tillett, William, Jadon, Deepak, Wallis, Dinny, Costa, Luisa, Waldron, Nicola, Griffith, Nina, Cavill, Charlotte, Korendowych, Eleanor, de Vries, Corinne, McHugh, Neil, Iaremenko, Oleg, Fedkov, Dmytro, Emery, Paul, Baeten, Dominique, Sieper, Joachim, Braun, Jurgen, van der Heijde, D., McInnes, Iain, Van Laar, Jaap, Landewe, R., Wordsworth, Bryan P., Wollenhaupt, Jurgen, Kellner, Herbert, Paramarta, I., Bertolino, Arthur, Wright, Andrew M., Hueber, Wolfgang, Sofat, Nidhi, Smee, Cori, Hermansson, Monika, Wajed, Julekha, Sanyal, Kaushik, Kiely, Patrick, Howard, Matthew, Howe, Franklyn A., Barrick, Thomas R., Abraham, Ajay M., Pearce, Mark S., Mann, Kay D., Francis, Roger M., Birrell, Fraser, Carr, Andrew, Macleod, Iain, Ng, Wan-Fai, Kavanaugh, Arthur, van der Heijde, Desiree, Chattopadhyay, Chandrabhusan, Gladman, Dafna, Mease, Philip, Krueger, Gerald, Xu, Weichun, Goldstein, Neil, Beutler, Anna, Baraliakos, Xenofon, Laurent, Didier D., Wollenhaupt, Jürgen, Gsteiger, Sandro, Conaghan, Philip G., Peterfy, Charles G., DiCarlo, Julie, Olech, Ewa, Alberts, Alan R., Alper, Jeffrey A., Devenport, Jenny, Anisfeld, Andrew M., Troum, Orrin M., Cooper, Philip, Gimpel, Mo, Deakin, Greg, Jameson, Karen, Godtschailk, Malcolm, Gadola, Stephan, Stokes, Maria, Cooper, Cyrus, Gordon, Caroline, Kalunian, K., Petri, M., Strand, V., Kilgallen, B., Barry, A., Wallace, D., Flurey, Caroline A., Morris, Marianne, Pollock, Jon, Hughes, Rod, Richards, Pam, and Hewlett, Sarah

Abstract

Background: Inflammatory back pain (IBP) is an early feature of ankylosing spondylitis (AS) and its detection offers the prospect of early diagnosis of AS. However, since back pain is very common but only a very small minority of back pain sufferers have ASpA or AS, screening of back pain sufferers for AS is problematic. In early disease radiographs are often normal so that fulfilment of diagnostic criteria for AS is impossible though a diagnosis of axial SpA can be made if MRI evidence of sacroiliitis is present. This pilot study was designed to indicate whether a cost-effective pick up rate for ASpA/early AS could be achieved by identifying adults with IBP stratified on the basis of age. Methods: Patients aged between 18 and 45 years who were referred to a hospital physiotherapy service with back pain of more than 3 months duration were assessed for IBP. All were asked to complete a questionnaire based on the Berlin IBP criteria. Those who fulfilled IBP criteria were also asked to complete a second short questionnaire enquiring about SpA comorbidities, to have a blood test for HLA-B27 and CRP level and to undergo an MRI scan of the sacroiliac joints. This was a limited scan, using STIR, diffusion-weighted, T1 and T2 sequences of the sacroiliac joints to minimize time in the scanner and cost. The study was funded by a research grant from Abbott Laboratories Ltd. Results: 50 sequential patients agreed to participate in the study and completed the IBP questionnaire. Of these 27 (54%) fulfilled criteria for IBP. Of these, 2 patients reported a history of an SpA comorbidity - 1 psoriasis; 1 ulcerative colitis - and 3 reported a family history of an SpA comorbidity - 2 psoriasis; 1 Crohn's disease. 4 were HLA-B27 positive, though results were not available for 7. Two patients had marginally raised CRP levels (6, 10 -NR ≤ 5). 19 agreed to undergo MRI scanning of the sacroiliac joints and lumbar spine; 4 scans were abnormal, showing evidence of bilateral sacroiliitis on S

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