title: Clinical characteristics of anterior chest wall pain in spondyloarthritis: an analysis of 275 patients.
abstract: OBJECTIVE
  Anterior chest wall pain is a common but little studied feature of spondyloarthritis. The objectives of our study were to assess the prevalence of anterior chest wall pain and to describe its clinical characteristics in a cohort of spondyloarthritis patients in a tertiary care center.
  
  
  METHODS
  
  
  
  METHODS
  retrolective single center observational study in 2010 (COSPA). Consecutive patients with definite spondyloarthritis according to Amor's criteria were included.
  
  
  METHODS
  each patient underwent direct interview by a physician. Prevalence of anterior chest wall pain, according to spondyloarthritis subtype and its date of appearance, localization and nature were collected.
  
  
  RESULTS
  In all, 275 consecutive spondyloarthritis patients were assessed. Among them, 102 patients (37.1%) suffered from spondyloarthritis-associated anterior chest wall pain. It was the first symptom of spondyloarthritis in 3.6% of cases. The prevalence after 5 and 10 years following the diagnosis of spondyloarthritis was 26.0% and 35.5%, respectively. Pain was usually in the upper chest and acute, increased by respiratory movements and movements of the arm; pain during the night was less frequent (41.0%). A flare lasted on average 5 weeks; recurrences were frequent (75%). Non-steroidal anti-inflammatory drugs and anti-tumor necrosis factor agents were reported as effective in 49.3% and 80.0% of cases, respectively.
  
  
  CONCLUSIONS
  Anterior chest wall pain was a frequent manifestation in spondyloarthritis. It occurred early in the disease course, but the risk persisted after disease onset. Better knowledge of the clinical characteristics of this symptom may help physicians for diagnosis and follow-up.
authors: Rheumatology B Department, Cochin Hospital, AP-HP, Medicine Faculty, Paris Descartes University, 27 rue du Faubourg-Saint-Jacques, 75014 Paris, France. Muriel-elhai@hotmail.fr
authors: Muriel
authors: M
authors: Elhai
authors: Simon
authors: S
authors: Paternotte
authors: Vincent
authors: V
authors: Burki
authors: Anne
authors: A
authors: Durnez
authors: Isabelle
authors: I
authors: Fabreguet
authors: Eugénie
authors: E
authors: Koumakis
authors: Magali
authors: M
authors: Meyer
authors: Judith
authors: J
authors: Payet
authors: Fanny
authors: F
authors: Roure
authors: Maxime
authors: M
authors: Dougados
authors: Laure
authors: L
authors: Gossec
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D002637:Chest Pain / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D025241:Spondylarthritis / Q000150:complications*; D035441:Thoracic Wall / Q000000981:diagnostic imaging / Q000473:pathology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha