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Joint Bone Spine
Volume 74, n° 4
pages 338-345 (juillet 2007)
Doi : 10.1016/j.jbspin.2007.04.001
Received : 19 December 2006 ;  accepted : 26 April 2007
Imaging for the diagnosis and follow-up of ankylosing spondylitis: Development of recommendations for clinical practice based on published evidence and expert opinion
 

Stephan Pavy a, Emmanuelle Dernis b, Frédéric Lavie c, Jean-Francis Maillefert d, Xavier Mariette c, Thierry Schaeverbeke e, Alain Cantagrel f, Pascal Claudepierre g, René-Marc Flipo h, Philippe Goupille i, Xavier Le Loet j, Alain Saraux k, Jacques Tebib l, Daniel Wendling m, Bernard Combe n,
a Service de Médecine Interne 1, CHU Pitié-Salpêtrière, Paris, France 
b Service de Rhumatologie, Centre Hospitalier, Le Mans, France 
c Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, France 
d Service de Rhumatologie, CHU, Dijon, France 
e Service de Rhumatologie, CHU Pellegrin, Bordeaux, France 
f Service de Rhumatologie, CHU Rangueil, Toulouse, France 
g Service de Rhumatologie, Hôpital Henri Mondor, Créteil, France 
h Service de Rhumatologie, CHRU Roger Salengro, Lille, France 
i Service de Rhumatologie, CHU, Tours, France 
j Service de Rhumatologie, CHU de Rouen, Bois-Guillaume, France 
k Service de Rhumatologie, CHU, Brest, France 
l Service de Rhumatologie, CHU Lyon sud, Pierre Benite, France 
m Service de Rhumatologie, CHU Jean Minjoz, Besançon, France 
n Service d'Immuno-Rhumatologie, CHU Lapeyronie, Hôpital Lapeyronie, 371 avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France 

Corresponding author. Tel.: +33 4 67 33 87 10; fax: +33 4 67 33 73 11.
Abstract
Objective

To develop recommendations regarding imaging studies for the diagnosis and follow-up of patients with axial forms of ankylosing spondylitis (AS) seen in everyday practice.

Methods

Evidence from the literature and expert opinion were used to develop the recommendations. Using the Delphi consensus procedure, a scientific committee selected five areas of interest, about which scientific evidence was sought by searching Medline and the databases maintained by the French Society for Rheumatology, European League against Rheumatism, and American College of Rheumatology. Based on this evidence, a panel of experienced rheumatologists drafted recommendations, using expert opinion if needed to supplement gaps in evidence. For each recommendation, the level of evidence and the extent of agreement among the experts were specified.

Results

The five areas of interest dealt with the usefulness of imaging studies for the diagnosis, follow-up, prognostic evaluation, and assessment of treatment responses in patients with AS. The literature search retrieved 144 articles based on titles and abstracts. After elimination of articles that did not include an analysis of the radiological evaluation of AS, 73 articles were left for review. Eight recommendations were drafted then validated by having all panel participants vote during a final meeting.

Conclusion

Eight recommendations about the use of imaging studies in patients with AS were developed. They can be expected to improve clinical practice uniformity and, in the longer term, to optimize the management of patients with AS.

The full text of this article is available in PDF format.

Keywords : Ankylosing spondylitis, Diagnostic imaging, Everyday medical practice, Recommendations




© 2007  Published by Elsevier Masson SAS.