The yield of a positive MRI of the spine as imaging criterion in the ASAS classification criteria for axial spondyloarthritis: results from the SPACE and DESIR cohorts.

Autor:	Ez-Zaitouni Z; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands., Bakker PA; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands., van Lunteren M; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands., de Hooge M; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands., van den Berg R; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands., Reijnierse M; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Fagerli KM; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway., Landewé RB; Amsterdam Rheumatology & Immunology Center (ARC), Amsterdam, The Netherlands., Ramonda R; Department of Medicine DIMED, University of Padova, Padova, Italy., Jacobsson LT; Department of Rheumatology, University ofGöteborg, Göteborg, Sweden., Saraux A; Department of Rheumatology, Laboratoire d'Immunothérapie et Pathologies, lymphocytaires B, Labex 'Immunotherapy, Graft, Oncology', Université Bretagneoccidentale, Bretagne, France., Lenczner G; Department of Radiology, Clinique Hartmann, Neuilly SurSeine, France., Feydy A; Department of Radiology, Paris Descartes University, Cochin Hospital, Paris, France., Pialat JB; Radiology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Claude-Bernard University, Pierre-Bénite, Bernard, France., Thévenin F; Department of Radiology, Paris Descartes University, Cochin Hospital, Paris, France., van Gaalen FA; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands., van der Heijde D; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Jazyk:	angličtina
Zdroj:	Annals of the rheumatic diseases [Ann Rheum Dis] 2017 Oct; Vol. 76 (10), pp. 1731-1736. Date of Electronic Publication: 2017 Jun 29.
DOI:	10.1136/annrheumdis-2017-211486
Abstrakt:	Objectives: To assess the prevalence of spinal inflammation on MRI in patients with chronic back pain (CBP) of maximally 3 years duration and to evaluate the yield of adding a positive MRI-spine as imaging criterion to the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial spondyloarthritis (axSpA). Methods: Baseline imaging of the sacroiliac joints (X-SI), MRI of the sacroiliac joints (MRI-SI) and MRI-spine were scored by ≥2 experienced central readers per modality in the SPondyloArthritis Caught Early (SPACE) and DEvenir des Spondylarthropathies Indifférenciées Récentes (DESIR) cohorts. Inflammation suggestive of axSpA was assessed in the entire spine. A positive MRI-spine was defined by the presence of ≥5 inflammatory lesions. Alternative less strict definitions were also tested. Results: In this study, 541 and 650 patients with CBP from the SPACE and DESIR cohorts were included. Sacroiliitis on X-SI and MRI-SI was found in 40/541 (7%) and 76/541 (14%) patients in SPACE, and in DESIR in 134/650 (21%) and 231/650 (36%) patients, respectively. In SPACE and DESIR, a positive MRI-spine was seen in 4/541 (1%) and 48/650 (7%) patients. Of the patients without sacroiliitis on imaging, 3/447 (1%) (SPACE) and 8/382 (2%) (DESIR) patients had a positive MRI-spine. Adding positive MRI-spine as imaging criterion led to new classification in only one patient in each cohort, as the other patients already fulfilled the clinical arm. Other definitions of a positive MRI-spine yielded similar results. Conclusion: In two cohorts of patients with CBP with a maximum symptom duration of 3 years, a positive MRI-spine was rare in patients without sacroiliitis on MRI-SI and X-SI. Addition of MRI-spine as imaging criterion to the ASAS axSpA criteria had a low yield of newly classified patients and is therefore not recommended. Competing Interests: Competing interests: None declared. (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu