MR signal in the sacroiliac joint space in spondyloarthritis: a new sign

Laloo, Frederiek; Herregods, Nele; Varkas, Gaëlle; Jaremko, Jacob L.; Baraliakos, Xenofon; Elewaut, Dirk; Bosch, Filip Van den; Verstraete, Koenraad; Jans, Lennart

doi:10.1007/s00330-016-4587-9

Cited by 31 publications

(25 citation statements)

References 21 publications

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“…Ankylosis of the sacroiliac joint is relatively insensitive for the diagnosis of axSpA, but demonstrates good specificity (23). Similarly, the presence of new bone formation/fat deposition in the joint space (which is referred to as backfill by some authors and typically manifests as increase in T1W signal in the joint space), demonstrates good specificity (30,35). The task force recommend that these features should increase diagnostic confidence where they are clearcut or definite, although it is important to highlight that early ankylosis can be difficult and may often be erroneously identified in healthy patients.…”

Section: Recommendation 6: In the Sijs And/or Spine The Presence Of Cmentioning

confidence: 99%

Recommendations for acquisition and interpretation of MRI of the spine and sacroiliac joints in the diagnosis of axial spondyloarthritis in the UK

et al. 2019

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Objectives To develop evidence-based recommendations on the use of MRI in the diagnosis of axial SpA (axSpA). Methods A working group comprising nine rheumatologists and nine musculoskeletal radiologists with an interest in axSpA was established, with support from the British Society of Spondyloarthritis (BRITSpA). Two meetings were held. In the first meeting, research questions were formulated. In the second meeting, the results of a systematic literature review designed to inform the recommendations were reviewed. An anonymized Delphi process was used to formulate the final set of recommendations. For each recommendation, the level of evidence and strength of recommendation was determined. The level of agreement was assessed using a 0–10 numerical rating scale. Results Two overarching principles were formulated, as follows: The diagnosis of axSpA is based on clinical, laboratory and imaging features (overarching principle 1), and patients with axSpA can have isolated inflammation of either the sacroiliac joints or the spine (overarching principle 2). Seven recommendations addressing the use of MRI in the assessment of patients with suspected axSpA were formulated, covering topics including recommended sequences, anatomical coverage, acquisition parameters and interpretation of active and structural MRI lesions. The level of agreement for each recommendation was very high (range 8.8–9.8). Conclusion A joint rheumatology and radiology consensus on the acquisition and interpretation of MRI in axSpA diagnosis was achieved, and a research agenda formulated. This consensus should help standardize practice around MRI and ensure a more informed, consistent approach to the diagnosis of axSpA.

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Section: Recommendation 6: In the Sijs And/or Spine The Presence Of Cmentioning

confidence: 99%

Recommendations for acquisition and interpretation of MRI of the spine and sacroiliac joints in the diagnosis of axial spondyloarthritis in the UK

et al. 2019

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“…Backfill and high T1 signal in the SIJ space were shown to be very specific for sacroiliitis in SpA (specificity of 96%). 51 Weakness: Up to now, no histopathologic correlation of backfill has been obtained, so it is unclear what this signal actually represents. Backfill has not been widely studied.…”

Section: Backfillmentioning

confidence: 99%

“…New insights: Backfill and high T1 signal in the SIJ space are very specific for sacroiliitis in SpA (96%). 51 Surprisingly, backfill or high T1 signal in the SIJ space has a high prevalence among SpA patients with sacroiliitis, resulting in a sensitivity of 38%. 51 The evolution of erosion to ankylosis via the repair tissue backfill was finally confirmed in a prospective observational cohort with 147 AS patients who met the modified New York criteria that showed that resolution of inflammation and reduction of erosion were each independently associated with the development of new backfill and fat metaplasia at 2 years on multivariate analysis.…”

Section: Backfillmentioning

confidence: 99%

Sacroiliitis in Axial Spondyloarthritis: Assessing Morphology and Activity

Jans

Egund

Eshed

et al. 2018

Semin Musculoskelet Radiol

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“… 115 , who defined it as a high signal intensity filling the sacroiliac joint space on T1-weighted images which could represent fat metaplastic tissue filling excavations in subchondral bone; however, the histopathological origin has not been assessed yet. Recently, studies confirmed that the ‘backfill sign’ had a high specificity for SpA (between 95.8% and 98%) 116 but the sensitivity was only 59% 117 . Therefore, its presence could be used to support the diagnosis of axial SpA, but its absence should not be used to exclude it.…”

Section: Imagingmentioning

confidence: 99%

Recent advances in ankylosing spondylitis: understanding the disease and management

2018

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The term spondyloarthritis refers to a group of immune-mediated diseases characterised by inflammation of the axial skeleton, peripheral joints, and entheses. Ankylosing spondylitis (AS) is the most common and characteristic of these entities and even though it was first described over two centuries ago, the understanding of the underlying disease mechanism remains incomplete. It is known that around 40% of patients with AS have subclinical bowel inflammation, suggesting that the origin of the disease could be in the gut. Also, more genes and new molecules have demonstrated a role in the pathogenesis of AS. In this review, we analyse the latest therapies for spondyloarthritis and the most relevant discoveries over the last three years, together with their implications for different aspects of the disease.

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MR signal in the sacroiliac joint space in spondyloarthritis: a new sign

Cited by 31 publications

References 21 publications

Recommendations for acquisition and interpretation of MRI of the spine and sacroiliac joints in the diagnosis of axial spondyloarthritis in the UK

Recommendations for acquisition and interpretation of MRI of the spine and sacroiliac joints in the diagnosis of axial spondyloarthritis in the UK

Sacroiliitis in Axial Spondyloarthritis: Assessing Morphology and Activity

Recent advances in ankylosing spondylitis: understanding the disease and management

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