ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 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: 654

MRI Lesion Definitions in Axial Spondyloarthritis: A Consensus Reappraisal from the Assessments in Spondyloarthritis International Society

Walter P. Maksymowych1, Robert G. Lambert2, Mikkel Østergaard3, Manouk de Hooge4, Susanne J Pedersen3, Alexander N Bennett5, Rubén Burgos-Vargas6, Iris Eshed7, Robert B.M. Landewé8, Pedro Machado9, Helena Marzo-Ortega10, Kay-Geert Hermann11, Denis Poddubnyy11, Martin Rudwaleit11, Joachim Sieper12, Désirée van der Heijde13, Irene van der Horst-Bruinsma14, Ulrich Weber15 and Xenofon Baraliakos16, 1University of Alberta, Edmonton, AB, Canada, 2University of Alberta, Edmonton, AB, Cameroon, 3COPECARE University of Copenhagen, Copenhagen, Denmark, 4Ghent University Hospital, Ghent, Belgium, 5Rheumatology, Imperial College, London, United Kingdom, 6Universidad Nacional Autonoma de Mexico, Mexico City, Mexico, 7Radiology, Sheba Medical Center, Tel Aviv, Israel, 8Academic Medical Center Amsterdam, Amsterdam, Netherlands, 9University College London, London, United Kingdom, 10University of Leeds, Leeds, United Kingdom, 11Charité Universitätsmeidzin Berlin, Berlin, Germany, 12Rheumatology, Charité Universitätsmeidzin Berlin, Berlin, Germany, 13Rheumatology, Leiden University Medical Ctr, Leiden, Netherlands, 14Rheumatology, VU University Medical Center, Amsterdam, Netherlands, 15University of Southern Denmark, Odense, Denmark, 16Rheumazentrum Ruhrgebiet Herne, Herne, Germany

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: classification criteria and spondylarthritis, MRI

  • Tweet
  • Email
  • Print
Session Information

Date: Sunday, October 21, 2018

Session 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:

There has been substantial progress in the characterization of MRI lesions in the sacroiliac joints (SIJ) and spine in axial spondyloarthritis (axSpA) since the last consensus-based reports from ASAS1,2. In particular, new data have emerged regarding structural lesions and the considerable evolution in their appearance according to the degree of inflammation. There is as yet a lack of international consensus on standardized definitions of all the lesions reported to date. Consequently, the ASAS MRI group was convened to evaluate the literature describing the spectrum of MRI lesions in axSpA and to generate a consensus update on standardized definitions for MRI lesions.


Methods:

The literature pertaining to MRI lesion definitions in axSpA was discussed at 3 meetings of the ASAS MRI group attended by 26 investigators (21 rheumatologists, 5 radiologists). The group reviewed the literature for MRI lesion definitions and decided by consensus which definitions would be retained, which required modification, and which required a new definition. The group also agreed on a set of reference images, a study design (ASAS MRImagine) for multi-reader assessment of lesion definitions using MRI scans from the ASAS classification cohort, a PowerPoint-based reader calibration module, and a study-specific interactive eCRF incorporating links to reference images for recording MRI data.


Results:

For definitions denoting signs of activity in the SIJ, there are no revisions to the most current ASAS definition of a positive MRI and for subchondral bone marrow inflammation1. Definitions for capsulitis and enthesitis are revised. A new definition, joint space enhancement, denotes increased signal on contrast-enhanced images in the joint space of the cartilaginous portion of the SIJ. This replaces the term ‘synovitis’ and a separate definition describes what constitutes joint space fluid. For signs of structural change in the SIJ, the definition for sclerosis is unchanged. A revised definition for a fatty lesion incorporates characteristics typical of axSpA, and for erosion requires both loss of cortical bone as well as adjacent marrow matrix on a T1W image. A new definition, fat metaplasia in the joint space (‘backfill’), denotes the reparative change on a T1W image at the site of erosion when signs of activity recede. The new definition for ankylosis stresses the continuity of bright marrow signal across the joint space on a T1W image while for bone bud, the signal does not bridge the joint. Spinal lesion definitions are divided into those that occur in defined central and lateral sagittal slices. The revised definition of a vertebral corner inflammatory lesion divides this into a regular (type A) and dimorphic (type B) lesion. A new definition for corner erosion requires both loss of cortical bone as well as adjacent marrow matrix. New definitions for new bone growth require bright signal on T1W images extending from the vertebral corner marrow or endplate, which may (ankylosis) or may not (bone spur) be continuous with the adjacent vertebra.


Conclusion:

The ASAS MRI group has generated a consensus-based update on MRI lesions in axSpA.

 

1.Lambert et al. Ann Rheum Dis 2016; 75:1958-1963

2.Hermann et al. Ann Rheum Dis 2012;71:1278–1288


Disclosure: W. P. Maksymowych, CaRE rthritis, 9; R. G. Lambert, None; M. Østergaard, None; M. de Hooge, None; S. J. Pedersen, None; A. N. Bennett, None; R. Burgos-Vargas, AbbVie, BMS, Janssen, Pfizer, and Roche., 5, 8,AbbVie Inc., 2; I. Eshed, None; R. B. M. Landewé, None; P. Machado, None; H. Marzo-Ortega, Janssen, 2,Abbvie, Celgene, Janssen, Lilly, Novartis, UCB, 5,Abbvie, Celgene, Lilly, Novartis, UCB, 6; K. G. Hermann, None; D. Poddubnyy, None; M. Rudwaleit, None; J. Sieper, None; D. van der Heijde, None; I. van der Horst-Bruinsma, AbbVie Inc., 2, 5,Pfizer, Inc., 2, 5,MSD, 2, 5,UCB, Inc., 2, 5; U. Weber, None; X. Baraliakos, None.

To cite this abstract in AMA style:

Maksymowych WP, Lambert RG, Østergaard M, de Hooge M, Pedersen SJ, Bennett AN, Burgos-Vargas R, Eshed I, Landewé RBM, Machado P, Marzo-Ortega H, Hermann KG, Poddubnyy D, Rudwaleit M, Sieper J, van der Heijde D, van der Horst-Bruinsma I, Weber U, Baraliakos X. MRI Lesion Definitions in Axial Spondyloarthritis: A Consensus Reappraisal from the Assessments in Spondyloarthritis International Society [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/mri-lesion-definitions-in-axial-spondyloarthritis-a-consensus-reappraisal-from-the-assessments-in-spondyloarthritis-international-society/. Accessed May 27, 2023.
  • Tweet
  • Email
  • Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/mri-lesion-definitions-in-axial-spondyloarthritis-a-consensus-reappraisal-from-the-assessments-in-spondyloarthritis-international-society/

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 »

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

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