[The re-evaluation of 140 patients diagnosed as ankylosing spondylitis and nonradiographic axial spondyloarthritis].
OBJECTIVE
To re-evaluate the diagnoses of ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (nr-axSpA) and analyze the incidence and reason of misdiagnosis.


METHODS
Patients who were previously diagnosed as AS and nr-axSpA before referrals to Peking Union Medical College Hospital (PUMCH) were re-evaluated by three rheumatologists of PUMCH according to the modified New York criteria for AS and Assessment of SpondyloArthritis international Society (ASAS) axial SpA classification criteria for nr-axSpA.


RESULTS
Totally 87 prior AS patients and 53 prior nr-axSpA patients were enrolled in this study. After re-evaluation, 57 patients were still diagnosed as AS and 16 patients were still diagnosed as nr-axSpA. The misdiagnosis incidences were 34.48% and 69.81%, respectively. The misdiagnosis incidence of nr-axSpA was higher than that of AS (P < 0.01).


CONCLUSIONS
The misdiagnosis of AS were mainly due to the misjudgment of sacroiliac joints by CT. The misdiagnosis of nr-axSpA were mainly due to the misjudgment of sacroiliac joints by magnetic resonance imaging. Moreover, the misuse of ASAS axial SpA classification criteria contributed to the misdiagnosis also.
Di-er
DE
Jin
Li-dan
LD
Zhao
Xiao-ping
XP
Yan
Dong-lin
DL
Hao
Jing
J
Liu
Department of Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100032, China. Email: zhaoyan_pumch 2002@yahoo.com.cn.
Yan
Y
Zhao
D000293:Adolescent; D000328:Adult; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D025241:Spondylarthritis / Q000000981:diagnostic imaging*; D013167:Spondylitis, Ankylosing / Q000000981:diagnostic imaging*; D055815:Young Adult