Patients with chronic back pain of short duration from the SPACE cohort: which MRI structural lesions in the sacroiliac joints and inflammatory and structural lesions in the spine are most specific for axial spondyloarthritis?

Hooge, M. de; Berg, Rosaline van den; Navarro-Compán, Victoria; Reijnierse, M.; Gaalen, F. van; Fagerli, K.; Landewé, Robert; Oosterhout, M. van; Ramonda, Roberta; Huizinga, Tom W J; Heijde, Desirée van der

doi:10.1136/annrheumdis-2015-207823

Cited by 98 publications

(91 citation statements)

References 23 publications

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“…A significant prevalence of BME lesions in the anterior vertebral corners was also observed on MRIs of the spine. Consistent with results reported in previous studies (23)(24)(25), the finding highlights the importance of the involvement of the spine from the very first phase of the inflammatory process in axSpA. A high prevalence of other inflammatory signs on MRI linked to enthesitis especially in the thoracic spine were found in our patients suggesting involvement of this district in the early stages of axSpA.…”

Section: N Discussionsupporting

confidence: 92%

Spine and sacroiliac joints on magnetic resonance imaging in patients with early axial spondyloarthritis: prevalence of lesions and association with clinical and disease activity indices from the Italian group of the SPACE study

et al. 2016

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summaryOur aim was to determine the prevalence of spine and sacroiliac joint (SIJ) lesions on magnetic resonance imaging (MRI) in patients with early axial spondyloarthritis (axSpA) and their correlation with disease activity indices. Sixty patients with low back pain (LBP) (≥3 months, ≤2 years, onset ≤45 years), attending the SpA-clinic of the Unità Operativa Complessa Reumatologia of Padova [SpondyloArthritis-Caught-Early (SPACE) study], were studied following a protocol including physical examination, questionnaires, laboratory tests, X-rays and spine and SIJ MRI. Positive spine and SIJ MRI and X-rays images were scored independently by 2 readers using the SPARCC method, modified Stoke ankylosing spondylitis spine score and New York criteria. The axial pain and localization of MRI-lesions were referred to 4 sites: cervical/thoracic/lumbar spine and SIJ. All patients were classified into three groups: patients with signs of radiographic sacroiliitis (r-axSpA), patients without signs of r-axSpA but with signs of sacroiliitis on MRI (nr-axSpA MRI SIJ+), patients without signs of sacroiliitis on MRI and X-rays (nr-axSpA MRI SIJ-). The median age at LBP onset was 29.05±8.38 years; 51.6% of patients showed bone marrow edema (BME) in spine-MRI and 56.7% of patients in SIJ-MRI. Signs of enthesitis were found in 55% of patients in the thoracic district. Of the 55% of patients with BME on spine-MRI, 15% presented presented a negative SIJ-MRI. There was a significant difference between these cohorts with regard to the prevalence of radiographic sacroiliitis, active sacroiliitis on MRI and SPARCC SIJ score. The site of pain correlated statistically with BME lesions in thoracic and buttock districts. Since positive spine-MRI images were observed in absence of sacroiliitis, we can hypothesize that this finding could have a diagnostic significance in axSpA suspected axSpA.

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Section: N Discussionsupporting

confidence: 92%

Spine and sacroiliac joints on magnetic resonance imaging in patients with early axial spondyloarthritis: prevalence of lesions and association with clinical and disease activity indices from the Italian group of the SPACE study

et al. 2016

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“…More recently, ASAS also developed criteria for a spine MRI highly suggestive of axial SpA based on spinal inflammatory lesions (5). Structural changes, such as erosions or fat depositions, can also be detected by MRI and have thus been studied both at the sacroiliac (SI) joint and the spine level in this regard (6)(7)(8)(9). Some cutoffs in the number of structural lesions might have a good specificity for axial SpA but are still not consensual to date (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Imaging Findings Suggestive of Axial Spondyloarthritis in Diffuse Idiopathic Skeletal Hyperostosis

Latourte

Charlon

Etcheto

et al. 2017

Arthritis Care & Research

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Objective. To describe the magnetic resonance imaging (MRI) findings in diffuse idiopathic skeletal hyperostosis (DISH) patients and to assess the proportion of DISH patients whose MRI findings would fulfill the Assessment of Spondyloarthritis International Society (ASAS) criteria for a positive MRI of axial spondyloarthritis (SpA). Methods. This study involved all DISH patients who had a spine or sacroiliac (SI) joint MRI performed between January 2009 and December 2014. Sociodemographic and clinical data were collected. Available radiographs and MRI were analyzed and blindly scored by an experienced reader, using the Spondyloarthritis Research Consortium of Canada (SPARCC) scores for both spine and SI joint MRI. Results. A total of 53 symptomatic DISH patients was included in the analysis. The mean AE SD SPARCC score of the spine was 18.3 AE 23.4. Thirty-five patients (67.3%) had at least 1 fatty corner. Thirty patients (57.7%) met the ASAS definition of a spine MRI suggestive of axial SpA, but only 6 patients (15.8%) with an available SI joint MRI had sacroiliitis according to ASAS criteria. Only 1 patient (3.3%) had ≥3 erosions on the SI joint. Conclusion. Inflammatory lesions of the spine are common on the MRI of symptomatic DISH patients, and more than half fulfilled the ASAS criteria for a spine MRI suggestive of axial SpA. However, only a few patients met the ASAS definition of active sacroiliitis, suggesting that MRI of the SI joint but not of the spine might allow the differential diagnosis of DISH versus axial SpA in the elderly.

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“…В нашем исследовании АСИ при МРТ был выявлен у половины пациентов с активным рПсА и преимущественным поражением перифериче-ских суставов. В связи с этим нам представляется перспе-ктивным проведение дальнейших исследований с коли-чественной оценкой выраженности АСИ при МРТ у дан-ной категории больных, поскольку считается, что нали-чие более пяти очагов остеита в области КПС является надежным дифференциально-диагностическим призна-ком аксСпA [16].…”

Section: Discussionunclassified

SPECIFIC FEATURES OF AXIAL SKELETON INVOLVEMENT IN EARLY PSORIATIC ARTHRITIS (The REMARCA TRIAL)

Логинова¹,

Коротаева²,

Смирнов³

et al. 2016

rsp

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Patients with chronic back pain of short duration from the SPACE cohort: which MRI structural lesions in the sacroiliac joints and inflammatory and structural lesions in the spine are most specific for axial spondyloarthritis?

Abstract: The presence of (1) at least five fatty lesions and/or erosions on MRI-SI, (2) at least five inflammatory lesions or (3) at least five fatty lesions on MRI-spine allows an acceptable discrimination of axSpA and no SpA, while assuring >95% specificity.

Cited by 98 publications

References 23 publications

Spine and sacroiliac joints on magnetic resonance imaging in patients with early axial spondyloarthritis: prevalence of lesions and association with clinical and disease activity indices from the Italian group of the SPACE study

Spine and sacroiliac joints on magnetic resonance imaging in patients with early axial spondyloarthritis: prevalence of lesions and association with clinical and disease activity indices from the Italian group of the SPACE study

Imaging Findings Suggestive of Axial Spondyloarthritis in Diffuse Idiopathic Skeletal Hyperostosis

SPECIFIC FEATURES OF AXIAL SKELETON INVOLVEMENT IN EARLY PSORIATIC ARTHRITIS (The REMARCA TRIAL)

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