Tunisian recommendations for the diagnosis and evaluation of Spondyloarthritis

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Published Jan 2, 2025
https://doi.org/10.62438/tunismed.v103i1.5565
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Vol. 103 No. 1 (2025): Tunis Med Jan 2025

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Wafa Hamdi
Department of Rheumatology, Kassab Institute of Orthopaedics, Mannouba. Faculty of Medicine, University of Tunis El Manar, Tunisia
Saoussen Zrour
Department of Rheumatology, Fattouma Bourguiba Hospital, Monastir. Faculty of Medicine of Monastir, University of Monastir, Tunisia
Kaouther Maatallah
Department of Rheumatology, Kassab Institute of Orthopaedics, Mannouba. Faculty of Medicine, University of Tunis El Manar, Tunisia
Mohamed Younès
Department of Rheumatology, Tahar Sfar Hospital, Mahdia. Faculty of Medicine of Monastir, University of Monastir, Tunisia
Alia Fazaa
Department of Rheumatology, Mongi Slim Hospital, La Marsa. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
Saoussen Miladi
Department of Rheumatology, Mongi Slim Hospital, La Marsa. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
Ahmed Laatar
Department of Rheumatology, Mongi Slim Hospital, La Marsa. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
Aicha Ben Tekaya
Department of Rheumatology, Charles Nicolle Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
Rawdha Tekaya
Department of Rheumatology, Charles Nicolle Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
Imen Gharsallah
Department of Rheumatology, Military Hospital of Tunis, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
Nadia Testouri
Department of Internal Medicine, Habib Thameur Hospital, Tunis, Tunisia
Khadija Baccouche
Department of Rheumatology, Farhat Hached Hospital, Sousse. Ibn El Jazzar Faculty of Medicine, University of Sousse, Tunisia
Ines Mahmoud
Department of Rheumatology, Charles Nicolle Hospital, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
Mohamed Manaa
Department of Internal Medicine, Hospital of the Internal Security Forces, La Marsa. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
Mohamed Montacer Kchir
Department of Rheumatology, Kassab Institute of Orthopaedics, Mannouba. Faculty of Medicine, University of Tunis El Manar, Tunisia

Abstract

Advancements in understanding SpA have greatly improved patient quality of life through early detection and effective treatment. However, non-specialist physicians often face challenges in identifying the early symptoms of SpA.


Aim: This study aims to assist healthcare practitioners in the early detection of SpA and to streamline management strategies by employing a standardized assessment protocol for adult patients with SpA. LITAR collaborated with fifteen rheumatologists to adhere to INEAS guidelines. The team created a comprehensive repository based on seven PICO questions and their answers. To create this repository, the team combined local Tunisian data and insights from relevant literature sources using a synthesis method.


Results: This research culminated in the formulation of twelve evidence-based recommendations for best practices, encompassing three critical domains. Firstly, it addresses the clinical indications and signs that should alert primary care physicians to consider a SpA diagnosis and promptly refer patients to rheumatologists. Secondly, it outlines the diagnostic procedures involved in confirming SpA. Lastly, it presents standardized methods for evaluating and monitoring the progression of SpA. To ensure the robustness of these recommendations, an independent reading group of 19 experts from various related specialties validated them. Subsequently, a panel of 54 Tunisian rheumatologists practicing in diverse sectors, including public health, academia, and the private sector, evaluated the strength of these recommendations. The strength ratings ranged from 8 to 9, with a degree of agreement spanning from 72% to 100%.


Conclusion: This guideline, developed with the support of LITAR and accredited by INEAS,...(abstract truncated at 250 words)

Keywords:

Spondylarthritis, recommandations, Tunisia, diagnosis referral and consultation, diagnostic imaging

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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