Rheumatology Medical News about low back pain; spondyloarthropathy

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Comparative study on low back pain misdiagnosed as spondyloarthropathy
Clinical Rheumatology, 05/22/09

Deng XL et al. – Study reports that the clinical features of different diseases with low back pain were different from each other and from those of spondyloarthropathy. The various criteria for spondyloarthropathy may be more effective in combination, along with other clinical information like these clinical features.

Methods

An investigation of the features of different diseases with low back pain misdiagnosed as spondyloarthropathy
The clinical and laboratory data of 24 cases in recent 3 yrs were comparatively and retrospectively analyzed
The diagnostic accuracy of ESSG criteria, Amor criteria, and the combination of them was also analyzed

Results

The final diagnoses of these 24 cases:
- 4 malignant tumors (retroperitoneal adipose sarcoma, advanced gastric carcinoma, ovarian papillary epithelioma, acute lymphocytic leukemia)
- 6 benign tumors (two parathyroid adenoma with hyperparathyroidism, one intraspinal lipoma, intraspinal ependymomas, sacral tubulocyst, and intraspinal schwannoglioma, respectively)
- Other 14 cases included:
  - fibromyalgia syndrome (3), osteitis condensans (3),
  - diffuse idiopathic skeletal hyperostosis (2), lumbar intervertebral disk protrusion (1),
  - congenital scoliosis (1), Wilson’s disease (1), ochronosis (1),
  - Fanconi syndrome (1) and hypophosphatemic rachiopathy (1)
Among pts with tumor, all except 3 pts had persistent low back pain w/o morning stiffness; aggravated at night and could not be relieved by rest or exercise
Symptoms could not be relieved by administration of multiple nonsteroidal anti-inflammatory drugs
11 pts had inflammatory low back pain defined by Calin
Of the total misdiagnosed cases, 54.17–83.33% could be prevented by application of ESSG criteria or Amor criteria, or a combination of them