Axial Spondyloarthritis Classification Using Sacroiliac Joint MRI

MRI examination of structural lesions of the sacroiliac joints and the spine may help identify and classify axial spondyloarthritis.
This article is part of Rheumatology Advisor’s 2017 in-depth coverage of ACR, which took place in San Diego, CA. Our staff will be reporting on the latest treatment advancements and research initiatives for spondyloarthritis. Click here to read more of Rheumatology Advisor‘s conference coverage.

SAN DIEGO — Magnetic resonance imaging (MRI) examination of structural lesions of the sacroiliac joints (SIJ) may help identify and classify axial spondyloarthritis (axSpA), according to findings from an observational cross-sectional multicenter study presented at the American College of Rheumatology 2017 Annual Meeting, held November 3-8.

MRIs of patients who had recently received an axSpA diagnosis (n=100) and of individuals with no axSpA diagnosis (n=98) were compared to determine whether structural lesions of the SIJ or of the thoracolumbar and/or cervicothoracic spine may be indicative of axSpA and to determine the utility of using MRI. Study participants without axSpA had been given a recent diagnosis of chronic back pain.

According to the findings, SIJ chronic lesions were more prevalent in study participants with axSpA vs in those without axSpA, but with chronic back pain (24% vs 16.8%). The investigators found that ≥3 subchondral bone erosions of the SIJ were significantly associated with axSpA discrimination. The rate of chronic lesions of the spine was similar in both groups. In addition, the presence of ≥5 subchondral bone erosions or fatty lesions was deemed the most discriminatory in diagnosing axSpA with a high level of specificity.

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According to the researchers, the findings of this study suggest “these definitions might be considered (in the future) to be integrated in axSpA classification criteria.”

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Molto A, Gossec L, Foltz V, et al. Erosions at the sacroiliac joints and fatty lesions at the spine are the most discriminant lesions for recent onset axial spondyloarthritis recognition. Presented at: American College of Rheumatology (ACR)/Association of Rheumatology Health Professionals (ARHP) Annual Meeting; November 3-8, 2017; San Diego, CA; Abstract 589.