RESUMO
Objective@#. Trauma has been proposed as a triggering factor of psoriatic arthritis (PsA), and the deep Koebner phenomenon was the suggested underlying mechanism. The relationship between spondyloarthritis (SpA) and trauma was only observed in PsA.This study investigated cases of SpA other than PsA that occurred after physical trauma and analyzed their clinical, laboratory, and radiologic features. @*Methods@#. We retrospectively reviewed the medical records of 213 patients who visited our hospital due to a suspicion of SpA and grouped them into post-traumatic-SpA (PT-SpA, n=12) and non-post-traumatic-SpA (non-PT-SpA, n=201). Baseline characteristics were compared between the two groups by cross-sectional manner. @*Results@#. Peripheral SpA was more common in PT-SpA than in non-PT-SpA. Active inflammation on sacroiliac joint (SIJ) magnetic resonance imaging (MRI) was more common in non-PT-SpA (83.5% vs. 54.5%, p=0.046). The modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) was significantly higher in the non-PT-SpA group (2.0 vs. 0.0, p=0.007). Symptom duration from the first SpA symptom to diagnosis tends to be longer in the non-PT-SpA group (2.0 vs. 0.5 years, p=0.079). @*Conclusion@#. PT-SpA patients more frequently showed peripheral SpA, a less active inflammatory lesion on SIJ MRI, and a lower mSASSS score. Further studies are needed to clarify whether physical trauma has a direct/indirect role in the pathogenesis of SpA or merely confers an opportunity to recognize SpA symptoms.
RESUMO
Background/Aims@#Double contour sign (DCS) is a representative ultrasonographic finding in gout. DCS is evidence of monosodium urate deposit in gouty arthritis and has been identified in some patients with asymptomatic hyperuricemia. However, the specific characteristics of asymptomatic hyperuricemia in patients with DCS have not yet been revealed. @*Methods@#We enrolled patients with incidentally found hyperuricemia. Baseline characteristics were compared between asymptomatic hyperuricemia patients with and without DCS. Logistic regression analysis was performed to determine associated factors for DCS in patients with asymptomatic hyperuricemia. @*Results@#A total of 62 patients with asymptomatic hyperuricemia were enrolled, and 22 of the patients showed DCS. The metatarsophalangeal were the most commonly affected joints, and differences between asymptomatic hyperuricemia patients with and without DCS were seen in aspects of class II obesity and nonalcoholic fatty liver disease (NAFLD). Multivariate logistic regression analysis demonstrated that class II obesity and NAFLD significantly increased the risk of DCS in asymptomatic hyperuricemia patients (odds ratio [OR], 6.58, p = 0.022; OR, 5.21, p = 0.020, respectively). @*Conclusions@#Asymptomatic hyperuricemia patients with class II obesity and NAFLD had increased risk of DCS. Determining the presence of crystal deposition, such as DCS, among patients with asymptomatic hyperuricemia might help determine whether early pharmacologic intervention is needed, especially with severe obesity or NAFLD.