Page 19 - SPONDYLOARTHRITIS IN COLOMBIA -

Outline of this thesis
In general terms, the objectives of this thesis were:
1. To assess the performance of SpA classification criteria in SpA patients from Colombia and to investigate the current use of diagnostics tests in clinical practice in Colombia.
2. To investigate the prevalence of comorbidities in SpA patients in Colombia and to explore if SpA is –like other rheumatological conditions - associated with periodontitis.
3. To describe the validation and language translation of the ASAS-HI in patients with SpA in Colombia.
4. To evaluate the implementation of the ASAS/OMERACT core set for axial SpA in world-wide clinical trials.
The new ASAS classification criteria have been applied in different clinical settings especially in Europe. However, the ASAS criteria had not yet been applied and tested in a South American population. Therefore, in chapter 2 a description of the performance of the ASAS classification criteria in a Colombian cohort of patients with SpA is presented and analysed in comparison to
other criteria sets. SI-MRI and HLA-B27 are widely used in the diagnosis of axSpA and have a prominent place in the ASAS classification criteria, not only as an entry criterion but also as a related SpA feature. The relevance of both tests as central parameters in defining the spectrum of SpA as a whole (classification) is clear. However, these test are rather costly and waiting time for
MRI is long in many countries, which jeopardises widespread use for diagnostic purposes in many countries among which Colombia. Many have suggested to preselect patients in the diagnostic work-up of SpA so that some unnecessary expenses for MRI/HLAB27 testing can be avoided. In chapter 3 we investigate the patient’s characteristics associated with the decision of the rheumatologist to request SI-MRI and/or HLA-B27 in clinical practice.
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