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Abstract Number: 253

Presence of Bone Marrow Edema and Structural Lesions on Magnetic Resonance Imaging of the Sacroiliac Joints in Young Military Recruits before and after 6 Weeks of Intensive Physical Training

Gaëlle Varkas1, Manouk de Hooge2, Thomas Renson3, Sophie De Mits4, Philippe Carron5, Peggy Jacques4, Muriel Moris6, Geert Souverijns7, Lennart Jans8, Dirk Elewaut9 and Filip van Den Bosch10, 1Laboratory for Molecular Immunology and Inflammation, Department of Rheumatology, VIB, Ghent University and Ghent University Hospital, Ghent, Belgium, 2VIB, Ghent University and Ghent University Hospital, Leiden, Netherlands, 3Rheumatology, Ghent University Hospital, GENT, Belgium, 4Ghent University Hospital, Ghent, Belgium, 5Department of Rheumatology, Ghent University Hospital, Ghent, Belgium, 6Military Hospital Queen Astrid, Neder-Over-Heembeek, Belgium, 7Jessa Hospital Hasselt, Hasselt, Belgium, 8Department of Radiology, Ghent University Hospital, Ghent, Belgium, 9VIB Inflammation Research Center, University of Ghent, Ghent, Belgium, 10Rheumatology, Ghent University Hospital, Gent, Belgium

Meeting: ACR/ARHP Annual Meeting 2017

Date of first publication: September 18, 2017

Keywords:

Session Information

Date: Sunday, November 5, 2017

Title: Imaging of Rheumatic Diseases Poster I

Session Type: ACR Poster Session A

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

Background/Purpose:
While MRI of the sacroiliac is a sensitive method for detection of bone marrow edema (BME) and structural lesions in axial spondyloarthritis (axSpA), there is only limited data regarding the specificity in a non-SpA population. Mechanical stress is considered to be an important factor in the pathogenesis of SpA. However, currently there are no data on the effect of intensive physical activity on the sacroiliac joints and how this could impact MRI findings of the sacroiliac joints (MRI-SIJ).

Methods:
Twenty-two military recruits underwent an MRI-SIJ before and after 6 weeks of intense and uniform physical training. Bone marrow edema (BME) and structural lesions were scored by 3 trained readers, blinded for time sequence and clinical findings. The Spondyloarthritis Research Consortium of Canada (SPARCC) score was used to assess BME and an adjusted method derived from the SPARCC scoring method was used to asses structural lesions: sclerosis, erosions, fatty lesions and ankylosis were scored per quadrant on 6 consecutive slices representing the cartilaginous part of the joint. Additionally, the agreement with the definition of a positive MRI defined by ASAS was evaluated.

Results:
At baseline, 40.9% (9/22) of recruits already presented with at least one BME lesion, whereas this number increased to 50.0% (11/22) at week 6 (p=0.625). In subjects displaying BME, the mean number of BME lesions was 2.4 (±0.4) at baseline, compared to 3.7 (±1.3) at week 6. Overall, the mean change in BME lesions over time in all 22 individuals was 0.9 (±0.6) (p=0.109). A positive MRI according to ASAS was present in 22.7% (5/22) of recruits at baseline, which increased to 36.4% at follow up (p=0.375). Structural lesions were present in 36.4% (8/22) of subjects at baseline, which increased to 50% subjects (11/22) after 6 weeks of intense physical training (p=0.453). There was a significant increase of MRI lesions over time when combining both structural and inflammatory lesions (p=0.038).

Conclusion:
We found a markedly high prevalence of BME and structural lesions in young, active, healthy volunteers, with almost 23% of them fulfilling the ASAS definition of a positive MRI. Overall, MRI lesions seem to increase after 6 weeks of intense physical training. Thus, our study underscores the necessity to interpret MRI findings of the sacroiliac joints in the appropriate clinical context, even in a young active population.

Disclosure: G. Varkas, None; M. de Hooge, None; T. Renson, None; S. De Mits, None; P. Carron, None; P. Jacques, None; M. Moris, None; G. Souverijns, None; L. Jans, None; D. Elewaut, Scientific Research Flanders; Research Council Ghent University; Interuniversity Attraction Pole., 2,Boehringer Ingelheim; Pfizer; UCB; Merck; Novartis; Janssen; Abbvie, 5; F. van Den Bosch, AbbVie Inc., Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer and UCB, 5,AbbVie Inc., Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer and UCB, 8.

To cite this abstract in AMA style:

Varkas G, de Hooge M, Renson T, De Mits S, Carron P, Jacques P, Moris M, Souverijns G, Jans L, Elewaut D, van Den Bosch F. Presence of Bone Marrow Edema and Structural Lesions on Magnetic Resonance Imaging of the Sacroiliac Joints in Young Military Recruits before and after 6 Weeks of Intensive Physical Training [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/presence-of-bone-marrow-edema-and-structural-lesions-on-magnetic-resonance-imaging-of-the-sacroiliac-joints-in-young-military-recruits-before-and-after-6-weeks-of-intensive-physical-training/. Accessed .

ACR Meeting Abstracts - https://acrabstracts.org/abstract/presence-of-bone-marrow-edema-and-structural-lesions-on-magnetic-resonance-imaging-of-the-sacroiliac-joints-in-young-military-recruits-before-and-after-6-weeks-of-intensive-physical-training/