Session Information
Date: Monday, November 9, 2015
Title: Imaging of Rheumatic Diseases Poster II: X-ray, MRI, PET and CT
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: It is known that in axial spondyloarthritis (axSpA)
inflammatory lesions on MRI of the SI joints (MRI-SI) can change over time. The
usefulness of repeating imaging in the diagnostic process is unclear. By this
study we aim to investigate how patients with short-term chronic back pain are
classified by the ASAS axSpA- criteria at baseline and after 1-year follow-up,
focussing on the role of imaging.
Methods: Patients in the SPACE-cohort (back pain: ≥ 3 months, ≤ 2
years, onset < 45 years) with (suspicion of) axSpA underwent MRI and X-rays
of the SI-joints at baseline and 1-year follow-up. Patients with complete MRI-
and X-SI data at both timepoints were included in the
analysis (n=185). MRI-SI and X-SI were scored by 3 different well-calibrated
readers independently according to the ASAS-definition for a positive MRI and
the mNY-criteria, blinded for patient characteristics and time sequence.
Fulfilment of ASAS-MRI or mNY-criteria was considered positive if 2/3 readers
agreed. At each timepoint, patients were classified
according the ASAS axSpA-criteria and grouped in the different arms (imaging
arm: mNY+/- or MRI+/-; clinical arm, fulfilment of both arms and possible
axSpA). At year one, in contrary to the normal application of the criteria, we
grouped patients according to the finding at that timepoint,
ignoring previous imaging findings.
Results: At baseline, 92/185 patients (49.7%) fulfilled the ASAS criteria
(clinical arm: 53; imaging arm: 15, both arms: 24) (table). At 1 year, 14
additional patients fulfilled the criteria (8 clinical arm; 5 imaging arm only;
1 both arms). After 1 year, in 12 patients MRI-SI became positive. As a
result,14/93 (15.1%) of the no SpA or possible SpA patients at baseline could
be classified additionally as axSpA because of additional SpA features (n=8), a
positive MRI (n=4) or sacroiliitis according to the mNY-criteria (n=2), On the
other hand, MRI-SI became negative after 1 year in 12 other patients. Of these
patients, 10 still fulfilled the ASAS criteria (clinical arm (n=7) or both arms
(n=3)). Only 4 patients (classified as axSpA at baseline) would be missed if
imaging would have been performed only at 1 year (due to negative MRI or x-ray
findings).
Conclusion: In our cohort, a significant number of patients with no SpA or possible
SpA at baseline developed (additional) SpA features
leading to fulfilment of axSpA criteria at year one.
Table:
impact of repeating imaging after 1 year on the ASAS axSpA
classification of patients
|
|
1 year
|
|||||||||||
|
Baseline
|
ASAS classification different arms
|
No SpA
|
Possible SpA
|
Clinical arm +
|
Imaging arm +
|
Both arms +
|
Total
|
|||||
|
mNY+ MRI+ |
mNY+ MRI- |
mNY- MRI+ |
mNY+ MRI+ |
mNY+ MRI- |
mNY- MRI+ |
|
||||||
|
No SpA |
18 |
12 |
|
|
1 |
1 |
|
|
|
32 |
||
|
Possible SpA
|
|
49 |
8 |
|
1 |
2 |
|
|
1 |
61 |
||
|
Clinical arm +
|
|
|
47 |
|
|
|
|
1 |
5 |
53 |
||
|
Imaging arm +
|
mNY+ MRI+ |
|
|
|
2 |
|
|
|
1 |
|
3 |
|
|
mNY+ MRI- |
1 |
1 |
|
|
2 |
|
|
1 |
|
5 |
||
|
mNY- MRI+ |
1 |
1 |
2 |
1 |
|
|
|
|
2 |
7 |
||
|
Both arms +
|
mNY+ MRI+ |
|
|
1 |
|
|
|
2 |
1 |
2 |
6 |
|
|
mNY+ MRI- |
|
|
3 |
|
|
|
1 |
|
2 |
6 |
||
|
mNY- MRI+ |
|
|
4 |
|
|
|
1 |
1 |
6 |
12 |
||
|
Total |
20 |
63 |
65 |
3 |
4 |
3 |
4 |
5 |
18 |
185 |
||
To cite this abstract in AMA style:
Bakker P, van Lunteren M, Ez-Zaitouni Z, van den Berg R, de Hooge M, Fagerli KM, Landewé RBM, van Oosterhout M, Ramonda R, Reijnierse M, van Gaalen F, van der Heijde D. Impact of Repeating Imaging of the Sacroiliac Joints after One Year on the Classification of Patients According the ASAS Axial Spa Criteria [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/impact-of-repeating-imaging-of-the-sacroiliac-joints-after-one-year-on-the-classification-of-patients-according-the-asas-axial-spa-criteria/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-repeating-imaging-of-the-sacroiliac-joints-after-one-year-on-the-classification-of-patients-according-the-asas-axial-spa-criteria/