ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1561

Findings Compatible with Axial Spondyloarthritis in Radiologist Reports

Rouhin Sen1, Emmeline Kim2, Evan Manning3, Eric Anderson4, Kyle Maier5, Elizabeth Cheng6 and Liron Caplan6, 1University of Colorado - Division of Rheumatology, Denver, CO, 2University of Colorado School of Medicine, Denver, 3University of Colorado - Department of Medicine, Denver, 4Washington University - Division of Rheumatology, St. Louis, 5United States Air Force, San Antonio, TX, 6Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO

Meeting: ACR Convergence 2020

Keywords: Ankylosing spondylitis (AS), Imaging, Plain Film, spondyloarthritis, X-ray

  • Tweet
  • Email
  • Print
Session Information

Date: Monday, November 9, 2020

Session Title: Imaging of Rheumatic Diseases Poster

Session Type: Poster Session D

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

Background/Purpose: The sacroiliac joint (SIJ) has a distinct anatomical shape that can pose challenges to standard planar imaging techniques making the detection of subtle changes difficult1. SIJ radiographs are a very important tool for the evaluation of disease in patients with suspected axial spondyloarthritis (axSpA). With lack of a reliable biomarker and limitations in physical examination, clinicians are reliant on the interpretation of plain films by radiologists, who may or may not be trained in musculoskeletal radiology2. This study characterizes the details reported by radiologists in their reports of SIJ radiographs and compares their scoring with formal interpretations by trained readers.

Methods: SIJ 3-view (Ferguson and obliques) radiographs of US Veterans enrolled in the Program to Understand Long-term Outcomes of Spondylarthritis (PULSAR) registry were evaluated by three trained readers using the scoring from the modified New York (mNY) criteria. Corresponding radiology reports were then evaluated for the presence of terms used to apply mNY scores (erosions, sclerosis, joint narrowing or widening, ankylosis, and blurring), descriptions regarding the severity of any abnormality (no abnormality, mild/possible abnormality, clear abnormality), and the presence of sacroiliitis or axSpA. Classification of sacroiliitis based on consensus mNY grade by trained readers was compared with corresponding radiologist interpretation. Radiograph interpretations were evaluated for association with HLAB27 status.

Results: Reports from 90 radiographs (180 joints) revealed that among patients described as having sacroiliitis or axSpA by the radiologist report, no particular finding was described more frequently than 20% when considering laterality separately and no finding was present more than 31% of the time when assessing either side for abnormalities. Similarly, among patients classified as axSpA by consensus of the three readers, no particular finding was described more frequently than 32% of the time when assessing either side. The most frequent described findings were ankylosis (31.2%) and erosions (29.0%). Compared with the gold-standard consensus interpretation by three trained readers, the radiologist report demonstrated a sensitivity of 57.6% (95% CI 44.1-70.4) and specificity of 93.3% (95% CI 68.1-99.8) for identifying sacroiliitis/axSpA. The strength of the association between HLAB27 status and classification of AS was also greater for the consensus of three readers (ß=0.465, R2=0.288) than the radiologist report (ß=0.319, R2=0.090).

Conclusion: In patients likely to have axSpA, radiology reports only describe specific findings suggestive of axSpA in a minority of cases.  Classification of axSpA by radiology reports is less well associated with HLAB27 status than a consensus of trained readers.  Rheumatologists should consider training to read SIJ radiographs themselves, rather than relying exclusively upon radiology reports.


Disclosure: R. Sen, None; E. Kim, None; E. Manning, None; E. Anderson, None; K. Maier, None; E. Cheng, None; L. Caplan, None.

To cite this abstract in AMA style:

Sen R, Kim E, Manning E, Anderson E, Maier K, Cheng E, Caplan L. Findings Compatible with Axial Spondyloarthritis in Radiologist Reports [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/findings-compatible-with-axial-spondyloarthritis-in-radiologist-reports/. Accessed July 1, 2022.
  • Tweet
  • Email
  • Print

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/findings-compatible-with-axial-spondyloarthritis-in-radiologist-reports/

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 »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2022 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies