Friday, 17 Aug 2018

You are here

MRI Imaging for Sacroiliitis Requires Bone Marrow Edema for Reliability

de Winter and colleagues from the Netherlands have reported on magnetic resonance imaging (MRI) of the sacroiliac (SI) joints of healthy subjects, patients with axial spondyloarthritis (SpA), runners and those with chronic back pain, and found a high incidence of sacroiliitis in many, but that deep bone marrow edema was most specific for those with axial SpA.

Three trained, experienced MRI readers assessed the SI joints of 172 subjects (47 healthy controls without low back pain (LBP), 47 axial SpA, 47 controls with chronic back pain, 7 with postpartum back pain, and 24 frequent runners) and scored these according to ASAS and SPARCC methods. The results are shown below:

 nHLA-B27+MRI Sacroiliitis

SPARCC Sacroiliitis

Deep Bone Marrow Edema

Axial SpA4774,5%91.5%97.7%89.4%
Normal controls47023.4%25.5%0
Chronic LBP4706.4%10.6%0
Post-partum LBP70 57.1%57.1%14.3%
Runners24012.5% 16.7%0

While some evidence of MRI sacroiliits may be found in minority of those with LBP, it appears that only deep (extensive) bone marrow edema lesions are most specific for axial SpA patients.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Back Pain in Psoriatic Arthritis

A single center study of psoriatic arthritis patients has shown that rheumatologist-judged inflammatory back pain (IBP) and criteria defining IBP may not perform well when ascertaining axial involvement in PsA patients. 

Minimal Disease Activity: The Goal in PsA

The majority of patients with psoriatic arthritis (PsA) who achieved a state of minimal disease activity (MDA) after 6 months of treatment with adalimumab (Humira) maintained that response through 24 months, a large observational study found.

Liver Disease Increased in Psoriasis

An observational case-control study has shown that psoriasis is associated with an increased prevalence of nonalcoholic fatty liver disease (NAFLD).

A single center, outpatient dermatology clinic studied 151 patients with psoriasis and 51 control subjects with ultrasonography to diagnose NAFLD.

Best of 2017: Cause of Death in Ankylosing Spondylitis

A French population based study of ankylosing spondylitis (AS) was report in the Journal of Rheumatology.

They analyzed the death certificates and cause of death in 2940 AS patients over 3 different decades (1969-78; 1979-99; 2000-2009).

The mortality rate of AS remained stable over time.

Ixekizumab Effective in Ankylosing Spondylitis

Eli Lilly announced today the results of the COAST-W trial showing that ixekizumab (Taltz) was effective in a Phase 3 study Ankylosing Spondylitis (AS) patients who had an inadequate response or intolerance to tumor necrosis factor (TNFi) inhibitor therapy.