title: Recently diagnosed axial spondyloarthritis: gender differences and factors related to delay in diagnosis.
abstract: A cohort of patients with recently diagnosed axial spondyloarthritis (SpA) was characterized with emphasis on gender differences and factors leading to delay in diagnosis. Clinical, laboratory, and imaging data of 151 consecutive patients diagnosed with ankylosing spondylitis or undifferentiated SpA in 2004-2009 and satisfying the new ASAS classification criteria for axial SpA, was collected and analyzed. Seventy-nine men and 72 women were enrolled. Both groups (men and women) had similar age of onset of disease-related symptoms, as well as similar delay time to diagnosis, follow-up duration and frequency of anti-TNF treatment. Inflammatory back pain, as a first symptom related to SpA, was reported more often by men, while women had more pelvic, heel, and widespread pain (WP) during the course of the disease. At the time of diagnosis, men were more limited in chest expansion and showed increased occiput-to-wall distance compared to women. Elevated erythrocyte sedimentation rate and/or C-reactive protein were detected in a similar proportion of men and women. Presence of WP in women almost doubled the delay in the diagnosis of SpA. No other differences in disease presentation or burden were demonstrated to correlate with delay in diagnosis.
authors.affiliation: Internal Medicine A, Bnai Zion Medical Center, Haifa, Israel. gslobodin@yahoo.com
authors.forename: Gleb
authors.initials: G
authors.lastname: Slobodin
authors.forename: Iris
authors.initials: I
authors.lastname: Reyhan
authors.forename: Nina
authors.initials: N
authors.lastname: Avshovich
authors.forename: Alexandra
authors.initials: A
authors.lastname: Balbir-Gurman
authors.forename: Nina
authors.initials: N
authors.lastname: Boulman
authors.forename: Mona
authors.initials: M
authors.lastname: Elias
authors.forename: Joy
authors.initials: J
authors.lastname: Feld
authors.forename: Reuven
authors.initials: R
authors.lastname: Mader
authors.forename: Doron
authors.initials: D
authors.lastname: Markovitz
authors.forename: Doron
authors.initials: D
authors.lastname: Rimar
authors.forename: Itzhak
authors.initials: I
authors.lastname: Rosner
authors.forename: Michael
authors.initials: M
authors.lastname: Rozenbaum
authors.forename: Devy
authors.initials: D
authors.lastname: Zisman
authors.forename: Majed
authors.initials: M
authors.lastname: Odeh
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D015331:Cohort Studies; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D012737:Sex Factors; D013131:Spine / Q000473:pathology*; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents