Prevalence of inflammatory back pain in a cohort of patients with anterior uveitis.
OBJECTIVE
To determine the prevalence of inflammatory back pain in an anterior uveitis cohort.


METHODS
Retrospective cohort study.


METHODS
Patients with anterior uveitis were recruited from the clinic of an ophthalmologist to complete a survey between March and December 2008. Patients were classified with inflammatory back pain if they had ≥2 positive responses to 4 validated inflammatory back pain questions: presence of morning stiffness >30 minutes in duration; improvement in back pain with exercise but not with rest; awakening from back pain during the second half of the night only; and presence of alternating buttock pain. Disease activity was assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The impact of disease on quality of life was measured using the EuroQOL (EQ-5D) questionnaire. Twenty-five patients underwent further rheumatologic examination.


RESULTS
One hundred forty-one of 167 patients (84.4%) completed the survey. Sixty-six of 141 patients (46.8%) were classified to have inflammatory back pain. Mean BASDAI (4.2, SD 2.41) and EQ-5D scores (0.73, SD 0.21) were lower than patients with no inflammatory back pain (0.82, SD 0.16, P = .0048). In the subgroup that underwent rheumatologic assessment, a classification of inflammatory back pain was 92% sensitive and 67% specific for a diagnosis of inflammatory back pain.


CONCLUSIONS
The prevalence of inflammatory back pain in a cohort of anterior uveitis patients was found to be 46.8%. Patients with inflammatory back pain had worse quality of life than those without. Ophthalmologists may use these questions on back pain to select patients classified to have inflammatory back pain to refer for early rheumatologic assessment.
Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada. clarachanmd@gmail.com
Clara C
CC
Chan
Taucha
T
Inrig
Catherine B
CB
Molloy
Millicent A
MA
Stone
Larissa
L
Derzko-Dzulynsky
D001416:Back Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D002170:Canada / Q000453:epidemiology; D005260:Female; D015796:HLA-B27 Antigen / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018434:Sickness Impact Profile; D025242:Spondylarthropathies / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology
D015796:HLA-B27 Antigen