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Comparison Between INSPIRE and Domjan method for measuring lumbar lateral flexion in patients of psoriatic arthritis (PsA) and correlation with radiographic damage

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Abstract

Objective

Assessment of spinal lateral flexion (SLF) is important in spondyloarthritis (SpA). The INSPIRE method of measuring SLF requires one set of measurements, is faster, feasible, and correlates with the mSASSS in ankylosing spondylitis. The present study aimed to compare the INSPIRE to Domjan method in PsA patients and correlate with radiographic changes.

Methods

Patients were selected from a cohort followed in a PsA clinic. Patients satisfying CASPAR criteria and having axial disease were identified. Clinical features were recorded. Examination included full spinal clinimetrics including measurement of INSPIRE and Domjan methods. Spine radiographs were scored for mSASSS by two assessors. Pearson correlation was used to correlate the values of spinal mobility measures and radiographic scores.

Results

Two hundred twenty-nine patients were included in the study. The mean age at study entry was 51 years (16–83) and mean disease duration was 14 years (0.1–49). Forty and 47% of patients had radiographic evidence of unilateral or bilateral sacroiliitis. The mean modified Schober was 4.5 (1–8 cm), SLF-Domjan 16.5 (3.5–40 cm), SLF-INSPIRE 31.5 (8–60 cm), and mSASSS score 4(0–48). Correlation (95% CI) between INSPIRE and Domjan method was 0.87 (0.82, 0.90), between INSPIRE, Domjan method, and mSASSS were − 0.36 (− 0.50, − 0.20) and − 0.34 (− 0.49, − 0.18) respectively. All correlations were significant. Comparable correlations were obtained with comparisons made in patients of PsA with axial disease only.

Conclusion

Both INSPIRE and Domjan methods correlate well as measures of SLF in PsA and correlate with radiographic damage. Therefore, the simpler INSPIRE method may be used to measure SLF in PsA.

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Acknowledgments

The authors thank Catherine T. Schentag for her help in data management and statistical analysis.

Funding

The PsA Clinic is supported by a grant from the Krembil Foundation. Anupam Wakhlu was supported by the Arthritis Centre of Excellence Fellowship and the Krembil Foundation.

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Authors and Affiliations

  1. Department of Rheumatology, King George’s Medical University, Lucknow, UP, India

    Anupam Wakhlu

  2. Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada

    Anupam Wakhlu, Vinod Chandran, Veerapong Phumethum & Dafna Gladman

  3. University of Calgary, Calgary, Alberta, Canada

    Hua Shen

  4. University of Waterloo, Waterloo, Ontario, Canada

    Richard J. Cook

  5. Psoriatic Arthritis Clinic, Centre for Prognosis Studies in the Rheumatic Diseases 1E-410B, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada

    Dafna Gladman

Authors
  1. Anupam Wakhlu
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  2. Vinod Chandran
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  3. Veerapong Phumethum
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  4. Hua Shen
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  5. Richard J. Cook
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  6. Dafna Gladman
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Corresponding author

Correspondence to Dafna Gladman.

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Wakhlu, A., Chandran, V., Phumethum, V. et al. Comparison Between INSPIRE and Domjan method for measuring lumbar lateral flexion in patients of psoriatic arthritis (PsA) and correlation with radiographic damage. Clin Rheumatol 38, 1063–1066 (2019). https://doi.org/10.1007/s10067-018-4375-9

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  • DOI: https://doi.org/10.1007/s10067-018-4375-9

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