Validity of magnetic resonance image and HLA-B27 in early detection of sacroiliitis in Egyptian spondyloarthropathic patients

Autor: Rawhya R El-Shereef, Amal Ali, Ayman Darwish, Fatma Ali, Mohammed Ibrahim, Lamia Hamdy
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: Egyptian Rheumatology and Rehabilitation, Vol 42, Iss 3, Pp 137-144 (2015)
Druh dokumentu: article
ISSN: 1110-161X
2090-3235
DOI: 10.4103/1110-161X.163946
Popis: Objective The aim of this study was to compare the validity of MRI in the early detection of sacroiliitis with laboratory findings of human leukocyte antigen-B27 (HLA-B27), conventional radiography, and clinical assessment. Participants and methods Sixty patients with spondyloarthropathy (group II) with duration of illness less than 2 years and 20 healthy controls (group I) were included in this study. Both groups were subjected to assessment of history, clinical examination, and laboratory investigations (erythrocyte sedimentation rate, C-reactive protein titer, rheumatoid factor, HLA-B27). Conventional radiography and MRI of the sacroiliac joints were performed. Spondyloarthropathic patients were divided according to MRI as follows: group IIA, which included patients with sacroiliitis, and group IIB, which included patients without sacroiliitis. Results In our study, ankylosing spondylitis was diagnosed in 22 (36.6%) patients, followed by undifferentiated spondyloarthropathy in 12 (20%) patients, reactive arthritis in 10 (16.7%) patients, psoriatic arthropathy in 10 (16.7%) patients, and enteropathic arthropathy in six (10%) patients. Evidence of sacroiliitis was found in 66.6% (40/60) of patients by MRI, which was higher than the result obtained by plain radiography 20% (12/60). HLA-B27 positivity found in 53.3% (32/60) of patients. There was a significant difference between the two groups in HLA-B27 and radiological sacroiliitis; there was no sacroiliitis in the control group. MRI showed sacroiliitis even in patients with no inflammatory back pain. There was a highly statistically significant difference between patient subgroups in disease duration (P = 0.001) and primary complaints and clinical sacroiliitis (P = 0.001). Conclusion MRI is the preferred modality in the detection of early sacroiliitis in spondyloarthropathy and HLA-B27 positivity is a highly useful predictor of early sacroiliitis
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