Clinical practice recommendations for the use of imaging in the diagnosis and management of axial spondyloarthritis in Taiwan

Abstract

Objective: Axial spondyloarthritis (axSpA) is a chronic inflammatory disease bearing challenges in early diagnosis. To improve clinical diagnosis and management of axSpA, recommendations were developed with current axSpA classification criteria and recent advances in medical imaging applications. Methods: A systematic literature review was conducted by 10 rheumatologists and radiologists in Taiwan to retrieve research evidence on the utilization of imaging modalities, including conventional radiography (CR), magnetic resonance imaging (MRI), computed tomography (CT), ultrasound (US), quantitative sacroiliac scintigraphy (QSS), and dual-energy X-ray absorptiometry (DXA). The panel of experts proposed six key issues on the role of imaging in early diagnosis of axSpA, monitoring of disease activity and structural changes, predicting treatment effects, and assessing complications such as osteoporosis and spinal fracture. The consensus was established on the basis of research evidence, clinical experiences and expert opinions. For each | 25 WEI Et al.

Editorial: Advances in Pathogenesis, Etiology, and Therapies for Ankylosing Spondylitis

“…AS causes inflammatory back pain and affects the spine and sacroiliac joints, which can lead to a drop in life quality of patients, as well as an increased burden to patients and society ( 2 ). In recent years, a growing number of studies have been conducted to investigate the pathogenesis and etiology, imaging techniques, and treatment in AS ( 3 – 7 ). In this Research Topic, there are three review articles and seven research articles published, mainly focusing on pathogenesis and etiology, diagnosis and therapies, and related assessment tools of AS.…”

IJRD in the Year of Tiger: We aim for an impact factor of 5 in the next 3 years

“…This principle has been significantly improved over the past few years. We have successively published the Asia‐Pacific guidelines or consensus recommendation articles for osteoarthritis, rheumatoid arthritis, lupus erythematosus, spondyloarthritis, gout, and other diseases 1‐13 . During the coronavirus disease 2019 (COVID‐19) pandemic, we have also published many practical guidelines, especially for the Asia‐Pacific region 10‐13 .…”

A Worthwhile Measurement of Early Vigilance and Therapeutic Monitor in Axial Spondyloarthritis: A Literature Review of Quantitative Sacroiliac Scintigraphy

“…For accurate diagnoses of SpA, QSS is only recommended when combined with a CT scan. 64 The importance of concomitant use of CT in the assessment of SI joints along with scintigraphy includes the following: the combination of semi-quantitative analysis of CT and quantitative analysis of SI joints can increase the unique specification of the risk level for active sacroiliitis; 65 CT is the gold standard for bone erosion and superior to conventional radiography and MRI, 65 it enables the crosssectional, multi-planar visualisation of the pathologic processes, which was better than conventional radiography, [66][67][68] in addition, the Modified New York Criteria scoring system for sacroiliitis can also applied to CT; by using spectral CT, fat deposition and bone marrow oedema can be measured similarly to MRI, which can increase the sensitivity for early changes of sacroiliitis; 65,68 and, other than bony erosion and relative water and calcium ratio of the SI joint, CT can detect sclerosis and syndesmophytes, which could be helpful to identify differential diagnoses in chronic changes in sacroiliitis. 65,68 Quantitative Sacroiliac Scintigraphy for Post-Streptococcal Reactive Arthritis Titers of anti-streptolysin O (ASLO) are of diagnostic value in the early detection of poststreptococcal reactive arthritis (PSRA), 48,[69][70][71] early arthritis after rheumatic fever, [72][73][74] and movement disorder.…”

“…92 Using auxiliary laboratory data and clinical scoring, including serum hs-CRP, vitamin D levels, erythrocyte sedimentation rate, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), clinicians may able to detect SI inflammation-related diseases from healthy controls. 93 A current article has suggested there is value of QSS in helping the differential diagnoses of back pain-associated conditions, such as suspected fracture, 64 particularly in survivors with SI joint pain after experiencing a vehicle accident.…”