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Open Access Research article

The prevalence of moderate to severe radiographic sacroiliitis and the correlation with health status in elderly Swedish men – The MrOS study

Sofia Exarchou16*, Inga Redlund-Johnell2, Magnus Karlsson13, Dan Mellström4, Claes Ohlsson4, Carl Turesson1, Lars Erik Kristensen1 and Lennart Jacobsson5

Author Affiliations

1 Department of Clinical Sciences, Lund University, Malmö, Sweden

2 Department of Radiology, Skåne University Hospital, Lund, Sweden

3 Department of Orthopedics and Molecular Osteoporosis Research Unit, Skåne University Hospital, Malmö, Sweden

4 Center for Bone and Arthritis Research at the Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden

5 The Sahlgrenska Academy, University of Gothenburg, Rheumatology anf Inflammation Research, Institute of Medicine, Gothenburg, Sweden

6 Rheumatological Department, University Hospital of Skåne, Inga Marie Nilssons gata 32, 205 02 Malmö, Sweden

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BMC Musculoskeletal Disorders 2013, 14:352  doi:10.1186/1471-2474-14-352

Published: 13 December 2013

Abstract

Background

Ankylosing Spondylitis (AS) is a chronic inflammatory disease with onset in young adults, but little is known about the prevalence in older age groups. Furthermore, there is very limited information of health status of elderly patients with AS. Our objective was to estimate the prevalence of moderate to severe radiographic sacroiliitis in elderly men and its impact on health.

Methods

A cross-sectional, population-based survey, that included 1005 men aged 69-81 years old, with the primary aim to study risk factors for osteoporosis (MrOS), was used. X-rays of the pelvis and spine were done for the whole population and then examined by two readers. The prevalences of grade 3-4 sacroiliitis, syndesmophytes and spondylophytes were ascertained. Using a self-administered questionnaire, information was obtained on physical activity (PASE), functional status (IADL items), health related quality of life - QoL (SF-12) and back pain (pain question, Quebec Pain Disability Scale items).

Results

Fourteen cases with grade 3-4 sacroiliitis were identified, corresponding to a prevalence of 1.4% (95%CI: 0.7-2.4). Eight of the patients with sacroiliitis had both AS-typical and degenerative changes in the spine, 4 had only degenerative changes and 2 had only AS-related changes. There were no statistically significant differences between those with and without radiographic sacroiliitis regarding demographics, anthropometric measures, smoking status or health status, reflected by measures on physical activity, functional status, health related QoL and back pain.

Conclusions

The prevalence of moderate to severe radiographic sacroiliitis was estimated to be 1.4% among elderly men in Sweden. Self-reported health was only slightly different in those with sacroiliitis, suggesting that the relative impact of AS is modest in this age group.