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Objectives The aim of this study was to evaluate the performance of a comprehensive diagnosis program called "Reuma-check" for the diagnosis of axial spondyloarthritis (SpA) in patients with low back pain (LBP). Methods This is a cross-sectional study. Patients with LBP aged 18 years or older were preselected, and those with at least 1 SpA feature completed the circuit. They were referred after 2 strategies: education for orthopedists and a campaign on social networks. All patients underwent a clinical evaluation, laboratory testing, and imaging (including human leukocyte antigen B27 evaluation and magnetic resonance imaging). The diagnosis of axial SpA was established by an expert rheumatologist opinion. Time from onset of symptoms to "Reuma-check," time from patient referral to admission of the checkup, and time from "Reuma-check" to diagnosis were evaluated. Results A total of 175 of 246 patients were included, most of them came from the social media campaign (55%). Seventy-five (43%) of 175 patients were diagnosed as axial SpA. The median time from referral (or self-referral) to access to the program was 1.3 months. The median time from symptoms onset to access to the program was 31.7 months, and the median time from the performance of "Reuma-check" to final diagnosis was 2 weeks. Features associated with a diagnosis of axial SpA were as follows: inflammatory LBP (odds ratio [OR], 6.64; 95% confidence interval [CI], 1.6-28), clinical enthesopathy (OR, 4.56; 95% CI, 1.1-18.4), positive human leukocyte antigen B27 (OR, 23.02; 95% CI, 3.5-58), and positive magnetic resonance imaging (OR, 14.34; 95% CI, 3.5-58). Conclusions "Reuma-check" allowed a high frequency of axial SpA diagnosis and improved access to rapid diagnosis, shortening the time from referral to diagnosis with a shorter acquisition time for the ancillary studies. Patients with a final diagnosis of axial SpA presented distinctive features.

To evaluate the performance of the European League Against Rheumatism (EULAR) definition of arthralgias suspicious for progression to RA in patients with hand arthralgias and to estimate the added value of both auto-antibodies and ultrasound (US) with power Doppler (PD).Consecutive patients admitted for hand arthralgias to "Reuma-check" ® program were included. This program includes the following at baseline: clinical assessment, laboratory tests, US with PD of both hands, and radiography of both hands and feet. All patients were followed-up after baseline evaluation by their treating rheumatologists, and a definitive diagnosis of RA (ACR/EULAR 2010 criteria) was established or not.A total of 465 consecutive patients were included. During follow-up, 44 (9.4%) were diagnosed with RA. Mean of baseline EULAR features describing arthralgia suspicious for progression to RA was 4.1 in patients with final diagnosis of RA vs 2.3 in non-RA patients (p 0.0001). The AUC for the EULAR defined features describing arthralgia suspicious for progression to RA for the final diagnosis of RA was 0.7827, while adding US with PD, rheumatoid factor (RF), and anti-cyclic citrullinated peptide antibodies (ACPA) data, the AUC was 0.9172 (p 0.0001). In the multivariate regression logistic analysis, baseline features associated with a final diagnosis of RA were difficulty with making a fist, RF, ACPA, and US with PD.EULAR definition of arthralgia suspicious for progression to RA had an acceptable performance to predict the future development of RA and improves adding information of both RF, ACPA and US with PD data.Key Points• Clinically suspect arthralgia may trigger rheumatologists to monitor patients closely for an early diagnosis.• EULAR definition of arthralgia suspicious for progression to RA predicts future development of arthritis.• Auto-antibodies and ultrasound improve EULAR definition of arthralgia suspicious for progression to RA.

To the Editor: Reported data of axial involvement in psoriatic arthritis (PsA) are variable (25–70%). This variability is mainly linked to different ways of defining this feature. Gladman1 established that the prevalence of axial involvement in PsA was close to 50% and that it is associated with HLA-B27. Likewise, psoriasis (PsO) spondylitis, unlike ankylosing spondylitis (AS), is characterized by not having a greater preponderance of the male sex, greater skin involvement, and a less severe course.2 We carried out an observational, cross-sectional, single-center study. The objective of our study was to estimate the frequency of axial involvement in patients with a recent diagnosis of PsA in a rapid diagnostic circuit called Reuma-Check3 and to carry out a comprehensive characterization (clinical, laboratory, and images). We also aimed to analyze the effect of axial involvement on other manifestations, and finally, to compare all features with a group of patients with axial spondyloarthritis (axSpA), diagnosed in the same circuit (with the same evaluators and the same imaging and laboratory techniques) in the same period of time, who did not present current PsO or history of PsO. This observational study was approved by an institutional ethics committee and was conducted in accordance with the current Declaration …

Introducción: Los datos reportados sobre el compromiso axial de la Artritis psoriásica (APs) son variables (25 al 70%), esta frecuencia esta vinculada a las diferentes formas de definirla. Objetivos: Estimar la prevalencia de compromiso axial en un grupo de pacientes diagnosticados de APs en el circuito Reuma-Check, realizar una caracterización clínica, laboratorio e imágenes y analizar las diferencias entre los pacientes que la presentan. Métodos: Pacientes que fueron admitidos al programa Reuma-Check con síntomas músculo esqueléticos: artralgias/artritis, dactilitis o entesitis asociado a psoriasis o antecedentes familiares. Una vez diagnosticados se interrogaba sobre la presencia de síntomas axiales: lumbalgia de más de 3 meses asociado al menos a uno de los siguientes: BASDAI >4, maniobras sacroiliacas y características inflamatorias. Se realizaba un segundo Reuma-Check para el estudio completo del compromiso axial (imágenes, HLA B27, BASFI). Resultados: De 139 pacientes 73 (52%) fueron finalmente diagnosticados de APs, 33% presentaban compromiso axial clínico. Se observo (con respecto a los que no tenían compromiso axial) mayor presencia de manifestaciones no musculo esqueléticas como uveítis e enfermedad inflamatoria intestinal, 42 vs 12 % (p: 0,004), mayor numero de entesitis 0,5 vs 0 (p: 0,04), y un compromiso funcional (HAQ) mayor, 0,8 vs 0,5 (p: 0002). En el análisis multivariado la presencia de manifestaciones no músculo esqueléticas y MASES se asociaron en forma independiente con el compromiso axial. Conclusión: La prevalencia de síntomas axiales fue de 33%, las características fueron inflamatorias y con actividad por BASDAI. Los pacientes con síntomas axial presentaban características de APS más severas.