title: Ultrasonographic evaluation of the anterior chest wall in spondyloarthritis: a prospective and controlled study.
abstract: OBJECTIVE
  To determine the prevalence and type of ultrasonographic (US) lesions of the anterior chest wall (ACW) in cases of spondyloarthritis (SpA).
  
  
  METHODS
  This monocentric, prospective, and controlled study included patients consulting for SpA (Assessment of Spondyloarthritis International Society criteria) and control subjects. Clinical (pain and swelling) and US assessments (synovitis, joint effusion, erosion, ankylosis, margin narrowing, or Doppler signal) were performed on the sternoclavicular (SCJ) and the manubriosternal (MSJ) joints. The main characteristics of SpA were recorded [disease duration, biologic features, Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), radiographic and extraarticular involvement].
  
  
  RESULTS
  The study included 131 patients with SpA and 49 control subjects (same age and sex ratio). Clinical and US involvement of ACW were found in, respectively, 39% and 35.5% of SpA and in 12% and 14.3% of controls (p < 0.01). US highlighted erosions (34 vs 0), margin narrowing (12 vs 0), power Doppler activity (18 vs 2; p < 0.05), and ankylosis of the MSJ (24 vs 3). US involvement was associated with disease duration (14.9 vs 11.1 years; p = 0.04), age (45 vs 41 years; p = 0.004), radiographic change of sacroiliac joint (p = 0.05), and presence of inflammatory bowel disease (IBD; p = 0.03). No associations were found with HLA-B27, psoriasis, enthesitis, uveitis, or clinical involvement of ACW. Clinical involvement is associated with a higher BASDAI (47 vs 32; p = 0.0009) and ASDAS (2.9 vs 2.2; p = 0.006).
  
  
  CONCLUSIONS
  US involvement of ACW is frequent in SpA (36.5%), mainly with erosion of SCJ and ankylosis of MSJ. It is associated with disease duration, radiographic sacroiliitis, and IBD.
authors.affiliation: From the Rheumatology Department, Centre Hospitalier Régional et Universitaire (CHRU) de Besançon, Besançon, France.F. Verhoeven, MD; X. Guillot, MD; M. Godfrin-Valnet, MD; C. Prati, MD, PhD, Assistant Professor; D. Wendling, MD, PhD, Professor, Rheumatology Department, CHRU de Besançon.
authors.forename: Frank
authors.initials: F
authors.lastname: Verhoeven
authors.affiliation: From the Rheumatology Department, Centre Hospitalier Régional et Universitaire (CHRU) de Besançon, Besançon, France.F. Verhoeven, MD; X. Guillot, MD; M. Godfrin-Valnet, MD; C. Prati, MD, PhD, Assistant Professor; D. Wendling, MD, PhD, Professor, Rheumatology Department, CHRU de Besançon.
authors.forename: Xavier
authors.initials: X
authors.lastname: Guillot
authors.affiliation: From the Rheumatology Department, Centre Hospitalier Régional et Universitaire (CHRU) de Besançon, Besançon, France.F. Verhoeven, MD; X. Guillot, MD; M. Godfrin-Valnet, MD; C. Prati, MD, PhD, Assistant Professor; D. Wendling, MD, PhD, Professor, Rheumatology Department, CHRU de Besançon.
authors.forename: Marie
authors.initials: M
authors.lastname: Godfrin-Valnet
authors.affiliation: From the Rheumatology Department, Centre Hospitalier Régional et Universitaire (CHRU) de Besançon, Besançon, France.F. Verhoeven, MD; X. Guillot, MD; M. Godfrin-Valnet, MD; C. Prati, MD, PhD, Assistant Professor; D. Wendling, MD, PhD, Professor, Rheumatology Department, CHRU de Besançon.
authors.forename: Clément
authors.initials: C
authors.lastname: Prati
authors.affiliation: From the Rheumatology Department, Centre Hospitalier Régional et Universitaire (CHRU) de Besançon, Besançon, France.F. Verhoeven, MD; X. Guillot, MD; M. Godfrin-Valnet, MD; C. Prati, MD, PhD, Assistant Professor; D. Wendling, MD, PhD, Professor, Rheumatology Department, CHRU de Besançon. dwendling@chu-besancon.fr.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D025241:Spondylarthritis / Q000000981:diagnostic imaging*; D013585:Synovitis / Q000000981:diagnostic imaging*; D035441:Thoracic Wall / Q000000981:diagnostic imaging*; D014463:Ultrasonography
keywords: ANTERIOR CHEST WALL; SPONDYLOARTHRITIS; ULTRASONOGRAPHY