Spine and Sacroiliac Joints Lesions on Magnetic Resonance Imaging in Early Axial-Spondyloarthritis During 24-Months Follow-Up (Italian Arm of SPACE Study)
| Autor: | Andrea Doria, Vanna Scapin, Augusta Ortolan, Marta Favero, Mariagrazia Lorenzin, Stefania Vio, Pamela Polito, Carmelo Lacognata, Mara Felicetti, Roberta Ramonda |
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| Rok vydání: | 2020 |
| Předmět: |
lcsh:Immunologic diseases. Allergy
Adult Male musculoskeletal diseases 0301 basic medicine medicine.medical_specialty diagnostic imaging disease process Immunology Physical examination spine Severity of Illness Index Young Adult 03 medical and health sciences 0302 clinical medicine Spondylarthritis Prevalence Humans Immunology and Allergy Medicine Prospective Studies BASDAI low back pain Pelvis Original Research inflammatory biomarkers medicine.diagnostic_test business.industry Sacroiliitis Enthesitis Sacroiliac Joint Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging Low back pain 030104 developmental biology medicine.anatomical_structure Italy Disease Progression Female Radiology Age of onset medicine.symptom lcsh:RC581-607 business Follow-Up Studies 030215 immunology |
| Zdroj: | Frontiers in Immunology Frontiers in Immunology, Vol 11 (2020) |
| ISSN: | 1664-3224 |
| DOI: | 10.3389/fimmu.2020.00936 |
| Popis: | Objectives: Our study aimed to identify: (1) the prevalence of spine and pelvis magnetic resonance imaging (MRI-spine and MRI-SIJ) inflammatory and structural lesions in patients (pts) with a diagnosis of axial spondyloarthritis (axSpA); (2) the predictive factors for a severe disease pattern with a higher probability of radiographic progression.Materials and Methods: Seventy-five pts with low back pain (LBP) (≥3 months, ≤2 years, onset ≤45 years) underwent physical examination, questionnaires, laboratory tests, X-rays, MRI-spine, and MRI-SIJ at baseline (T0) and during a 24-months follow-up. Two expert rheumatologists made axSpA diagnosis and classification (according ASAS criteria). MRI-spine, MRI-SIJ and X-rays were scored independently by 2 readers following the SPARCC, mSASSS, and mNY-criteria. According to ASAS criteria, 21 pts fulfilled imaging arm only and 29 clinical arm with/without imaging arm; 25 pts did not fulfill ASAS criteria.Results: At T0 the mean ± SD LBP onset was 28.51 ± 8.05 years, 45.3% pts were male, 38.7% were HLA-B27+; 56% showed bone marrow oedema (BMO) at MRI-spine and 64% at MRI-SIJ. Signs of enthesitis were found in 58% pts in the thoracic spine. Eighteen (24%) pts presented BMO at MRI-spine with a negative MRI-SIJ. The prevalence of BMO lesions and the SPARCC SIJ and spine score decreased during the follow-up in the 2 cohorts meeting ASAS criteria. An early onset of LBP, a lower use of NSAIDs, a BASDAI>4 were identified as predictors of spine structural damage; the high SPARCC SIJ score appeared to be a predictor of SIJ structural damage. A higher mSASSS was predicted by a lower age of onset of LBP. Predictor of higher SPARCC spine was a higher NSAIDs and of higher SPARCC SIJ score the HLA-B27 positivity with increased inflammatory biomarkers.Conclusions: At T0 a significant prevalence of BMO lesions was observed both in SIJ and spine, with predominant involvement of thoracic district. Since positive MRI-spine images were observed in the absence of sacroiliitis, these findings seem to be relevant in the axSpA diagnosis. Early age of disease onset, long duration of LBP, increased inflammatory biomarkers, higher use of NSAIDs, male gender, HLA-B27 positivity, SPARCC SIJ score>2 appeared predictors of radiological damage and activity. |
| Databáze: | OpenAIRE |
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