Diagnostic Value of MRI in Non-Radiographic Axial Spondyloarthritis

Tamara Rusman¹, Marie-Luise John², Mignon van der Weijden², Bouke Boden³, Joyce van der Bijl², Stefan Bruijnen⁴, Conny van der Laken⁵, Michael T. Nurmohamed⁶ and Irene van der Horst-Bruinsma⁷, ¹Rheumatology, VU University medical centre, Amsterdam, Netherlands, ²Amsterdam Rheumatology immunology Center |Department of Rheumatology VU University Medical Center, Amsterdam, Netherlands, ³Radiology, VU University Medical Center, Amsterdam, Netherlands, ⁴Dept. of Rheumatology, Amsterdam Rheumatology and immunology Center - location VU University Medical Center, Amsterdam, The Netherlands, Amsterdam, Netherlands, ⁵Amsterdam Rheumatology and immunology Center, Location VU University Medical Center, Amsterdam, Netherlands, ⁶Rheumatology, Amsterdam Rheumatology and immunology Center, VU University Medical Center, Amsterdam, Netherlands, ⁷Rheumatology, VU University Medical Center, Amsterdam, Netherlands

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: MRI, non-radiographic and spondylarthritis

Session Information

Date: Sunday, October 21, 2018

Title: Imaging of Rheumatic Diseases Poster I: MRI

Session Type: ACR Poster Session A

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

Background/Purpose: Few studies showed signs of inflammation at the MRI of the sacroiliac joints (SIJ) or spine in only 30% of the non-radiographic axial spondyloarthritis (nr-axSpA) patients ⁽¹⁾. Aims: 1) to evaluate inflammation at the MRI of the SIJ/ spine in TNF naïve nr-axSpA patients 2) consistency in case of absence of inflammation after 6 months and 3) evaluate gender differences

Methods: Consecutive patients with inflammatory back pain who were either HLA-B27 positive with ≥1 SpA-feature or HLA-B27 negative with ≥2 SpA-features, with high disease activity (BASDAI≥4), had an MRI of the SIJ and spine. In case of absence of inflammation, the MRI was repeated after six months. MRI images were scored according to the Spondyloarthritis Research Consortium of Canada (SPARCC spine, range 0-108; SPARCC SIJ, range 0-72) method

Results: Included were 70 patients, of whom 37 (53%) females. Half of the patients (36/69,52.2%) showed signs of inflammation on the first MRI: 27/69 patients (39.1%) at the SIJ, 14/46 patients (30.4%) at the spine and 4 patients (5.8%) on both sites and one patient missed the baseline MRI. Males had more often a positive MRI compared to females 62.5% vs. 43.2%. Patients with a positive MRI showed a median SPARCC score for SIJ of 8.0 (IQR: 1.8-23.5, higher in females) and for spine 6.5 (IQR: 2.8-10.8, higher in males).Only 4/33 patients (12.1%) showed a positive MRI after six months.

Conclusion: Fifty percent of the patients with nr-axSpA and high disease activity showed inflammatory lesions at the MRI of the SIJ and/or spine, which occurred more often in males compared to females. In most cases (87.9%) a MRI without inflammatory lesions remained negative after 6 months, indicating that a second MRI after a short period is not valuable.

Disclosure: T. Rusman, None; M. L. John, None; M. van der Weijden, None; B. Boden, None; J. van der Bijl, None; S. Bruijnen, None; C. van der Laken, None; M. T. Nurmohamed, AbbVie Inc., 2, 5,Pfizer, Inc., 2, 5,Merck & Co., 2, 5,Roche, 2, 5,BMS, 2, 5,UCB, Inc., 2, 5,Eli Lilly and Co., 2, 5,Celgene Corporation, 2, 5,Janssen, 2, 5; I. van der Horst-Bruinsma, AbbVie Inc., 2, 5,Pfizer, Inc., 2, 5,MSD, 2, 5,UCB, Inc., 2, 5.

To cite this abstract in AMA style:

Rusman T, John ML, van der Weijden M, Boden B, van der Bijl J, Bruijnen S, van der Laken C, Nurmohamed MT, van der Horst-Bruinsma I. Diagnostic Value of MRI in Non-Radiographic Axial Spondyloarthritis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/diagnostic-value-of-mri-in-non-radiographic-axial-spondyloarthritis/. Accessed .

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