ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 651

Analysis of the Different Value of Magnetic Resonance Imaging Changes in the Sacroiliac Joints for a Diagnosis of Axial Spondyloarthritis As Judged By Rheumatologists and Radiologists

Xenofon Baraliakos1, Ana Ghadir2, Martin Fruth2, Uta Kiltz3 and Jürgen Braun1, 1Ruhr-University Bochum, Herne, Germany, 2Rheumazentrum Ruhrgebiet, Herne, Germany, 3Rheumatology, Rheumazentrum Ruhrgebiet, Herne, and Ruhr University Bochum, Herne, Germany

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: axial spondyloarthritis, bone marrow lesions and inflammation, MRI

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, October 21, 2018

Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster I: Imaging, Clinical Studies, and Treatment

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Classification of axial spondyloarthritis (axSpA) by the imaging arm of the ASAS criteria relies partly on the detection of a bone marrow edema (BME) in the magnetic resonance imaging (MRI) of the sacroiliac joints (SIJ) suspicious of SpA. Here we evaluate different types of MRI changes possibly relevant for a diagnosis of axSpA as judged by radiologists taking the rheumatologist´s diagnosis as gold-standard.

Methods: Consecutive patients <45 years were included if they presented with chronic low back pain (duration >3 months) and underwent complete diagnostic workup including SIJ-MRI. All clinical and laboratory information including images but no radiological reports was available for experienced rheumatologists to make a diagnosis of axSpA or non-axSpA. In parallel, two experienced musculoskeletal radiologists, blinded to patients’ demographics and symptoms (except for back pain) evaluated all MR images without knowledge of the rheumatologist´s diagnosis, by quantification of BME, fat metaplasia, erosions, sclerosis and ankylosis based on the Berlin SIJ score. The radiologists also stated whether the patient is likely to have axSpA or not, solely based on MRI findings.

Results:

A total of 100 patients were recruited. The rheumatologist diagnosed axSpA in 54 patients (mean age 31.5±8.0 years, 77.8% HLA-B27+, mean symptom duration 36.4±42.0 months), while 46 patients were diagnosed as non-specific back pain (age 33.6±7.1 years, 17.4% HLA-B27+, mean symptom duration 25.5±31.6 months). According to the radiologists, 38 patients were identified as axSpA, 34 of which were also diagnosed as axSpA by the rheumatologist (overall agreement with the clinical diagnosis: 63%), and 4 patients were thought to have axSpA by the radiologist but not by the rheumatologist (disagreement with the clinical diagnosis: 8.7%). Similarly, the quantification of MRIs showed higher scores in patients diagnosed as axSpA by the rheumatologist. Only few patients had sclerosis or ankylosis.

From the radiologist´s perspective, the calculated odds ratio (OR) for identification of axSpA by MRI only was 3.1 (95% CI:1.4-7.1) for the presence of BME, 3.5 (95% CI:1.4-9.0) for fat metaplasia, 2.8 (95% CI:1.1-7.0) for erosions, 2.0 (95% CI:0.7-5.5) for ankylosis. For the combination of BME and any structural change, the OR was 3.7 (95% CI:1.6-8.5).

Conclusion:

This study reveals a discrepancy between the rheumatologist’s and the radiologist’s identification of axSpA, confirming that a diagnosis of axSpA in daily practice should not rely on imaging findings only. Nevertheless, the overall specificity of the radiologists was acceptable, although the sensitivity was relatively low. These data suggest also that not only BME but also fat metaplasia and erosions are of value to diagnose axSpA, beyond classification. The combination of MRI changes seems to enhance the discriminative diagnostic performance. Finally, it will be important to define clinically relevant cut offs for the MRI scores.


Disclosure: X. Baraliakos, None; A. Ghadir, None; M. Fruth, None; U. Kiltz, None; J. Braun, None.

To cite this abstract in AMA style:

Baraliakos X, Ghadir A, Fruth M, Kiltz U, Braun J. Analysis of the Different Value of Magnetic Resonance Imaging Changes in the Sacroiliac Joints for a Diagnosis of Axial Spondyloarthritis As Judged By Rheumatologists and Radiologists [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/analysis-of-the-different-value-of-magnetic-resonance-imaging-changes-in-the-sacroiliac-joints-for-a-diagnosis-of-axial-spondyloarthritis-as-judged-by-rheumatologists-and-radiologists/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/analysis-of-the-different-value-of-magnetic-resonance-imaging-changes-in-the-sacroiliac-joints-for-a-diagnosis-of-axial-spondyloarthritis-as-judged-by-rheumatologists-and-radiologists/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology