Rebuttal: A rare co-occurrence of anti-CCP-positive rheumatoid arthritis with sacroiliitis
DOI:
https://doi.org/10.15305/ijrci/v8i1/336Keywords:
rheumatoid arthritis, sacroiliitis, anti-CCP, spondyloarthritis, SpAAbstract
I thank Dr. Dalal for the detailed review and appreciate his commentary. The patient had clinically diagnosed anti-CCP-positive rheumatoid arthritis (RA) and she responded well to DMARDs. She had a low back pain of acute onset during the treatment for RA, which impaired her routine activities. Previous X-rays of the pelvis and LS spine were not available with the patient. An MRI was done to rule out disc lesion /SI joint pathology. I fully agree with the comment that the chronicity should be determined by the clinical symptoms and not by MRI. But the presentation of low back pain in females is atypical and many a time, the symptom cannot fit in as a criterion. Even in spondyloarthritis (SpA) with peripheral features as predominant manifestation, 25% can have asymptomatic sacroiliitis.
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