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: 778

Spinal MRI Has Little Incremental Diagnostic Value Compared with MRI of the Sacroiliac Joints Alone in Early Spondyloarthritis

Ulrich Weber1, Veronika Zubler2, Zheng Zhao3, Robert GW Lambert4, Stanley Chan5, Susanne Juhl Pedersen6, Mikkel Ostergaard7 and Walter P. Maksymowych8, 1Rheumatology, Balgrist University Hospital, Zurich, Switzerland, 2Radiology, Balgrist University Hospital, Zurich, Switzerland, 3Department of Rheumatology, University of Alberta and PLA General Hospital, Beijing, PR China, Beijing, AB, China, 4Radiology, University of Alberta, Edmonton, AB, Canada, 5Division of Ophthalmology, University of Alberta, Edmonton, AB, Canada, 6Copenhagen Center for Arthritis Research, Copenhagen University Hospital at Glostrup, Copenhagen, Denmark, 7Dept of Rheumatology RM, Copenhagen University Hospital, Glostrup, Denmark, 8Department of Medicine, University of Alberta, Edmonton, AB, Canada

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: diagnosis, Magnetic resonance imaging (MRI) and spondylarthropathy

  • Tweet
  • Email
  • Print
Session Information

Session Title: Spondylarthropathies and Psoriatic Arthritis - Clinical Aspects and Treatment: Spondyloarthritis I

Session Type: Abstract Submissions (ACR)

Background/Purpose: The definition of a positive MRI as major criterion in the Assessment of SpondyloArthritis classification criteria for axial spondyloarthritis (SpA) is based on MRI of the sacroiliac joints (SIJ) alone. It is not known whether additional MRI of the spine may enhance diagnostic certainty over and above SIJ MRI alone. We aimed to assess the incremental diagnostic value of spinal MRI evaluated both separately from and combined with SIJ MRI in early SpA compared to SIJ MRI alone.

Methods: The study sample comprised 2 independent cohorts A/B of 130 consecutive patients with back pain ≤50 years newly referred to 2 university clinics, and 20 healthy controls (HC), in whom both SIJ and spinal MRI were available. Patients were classified according to clinical examination and pelvic radiography as having non-radiographic SpA (nr-axSpA; n=50), ankylosing spondylitis (AS; n=33), or mechanical back pain (MBP; n=47). SIJ and spinal MRI were assessed by 3 blinded readers according to standardized modules. Readers recorded presence/absence of SpA and their level of confidence in this conclusion by global evaluation of the MRI scans on a 0-10 scale (0 = definitely not SpA; 10 = definite SpA). SIJ alone and spinal MRI alone were read independently 6 months apart, with another interval of 1-3 months to the combined assessment of both SIJ and spinal MRI (combined read). We analysed differences between SIJ alone versus spinal MRI alone, and SIJ alone versus combined read of SIJ and spinal MRI. This was done descriptively by the number/percentage of subjects recorded concordantly by any 2 readers for each group and for the 2 cohorts.

Results: For cohorts A and B, respectively, and for assessment of SIJ and spinal scans independently there were 0% and 16.1% of nr-axSpA patients who showed spinal lesions in the absence of SIJ lesions, while 15.8% and 19.4% of nr-axSpA patients considered having a negative SIJ MRI showed a positive spinal MRI according to global assessment. Low confidence (5-7) in a diagnosis of SpA by global evaluation of SIJ MRI increased to high confidence (8-10) by global evaluation of spinal MRI in only 0% and 3.2% of nr-axSpA patients in the 2 cohorts. For cohorts A and B, 5.3% and 3.2% of nr-axSpA patients considered negative for SpA by SIJ MRI scan alone were re-classified as being positive for SpA by global evaluation of combined SIJ and spinal scans. 57.1% and 30.3% of the MBP patients (cohort A/B) showed lesions only on spinal MRI. Up to 15.0% and 18.2% of all controls were considered as having SpA by spinal MRI scan alone, based on spinal BME in 60.9% and on fat infiltration in 26.1% of these subjects.

Number (percentage) of subjects as recorded concordantly by any 2 readers for comparisons of SIJ alone versus spinal MRI alone, and SIJ alone versus combined SIJ and spinal MRI read

Cohort Cohort A (n=62) Cohort B (n=88)
Group nr-axSpA AS MBP HC nr-axSpA AS MBP
Number of subjects 19 9 14 20 31 24 33
Lesions SIJ-/Spine+ 0 (0) 0 (0) 8 (57.1) 7 (35.0) 5 (16.1) 0 (0) 10 (30.3)
Global SIJ-/Spine+ 3 (15.8) 0 (0) 1 (7.1) 3 (15.0) 6 (19.4) 0 (0) 6 (18.2)
Global SIJ-/Combination read+ 1 (5.3) 0 (0) 0 (0) 0 (0) 1 (3.2) 0 (0) 0 (0)
Global Spine-/Combination read+ 7 (36.8) 2 (22.2) 0 (0) 1 (5.0) 5 (16.1) 6 (25.0) 4 (12.1)

Conclusion: Spinal MRI adds little incremental value compared to SIJ MRI alone in terms of lesion detection and classification of early SpA patients.


Disclosure:

U. Weber,
None;

V. Zubler,
None;

Z. Zhao,
None;

R. G. Lambert,
None;

S. Chan,
None;

S. J. Pedersen,
None;

M. Ostergaard,
None;

W. P. Maksymowych,
None.

  • Tweet
  • Email
  • Print

« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/spinal-mri-has-little-incremental-diagnostic-value-compared-with-mri-of-the-sacroiliac-joints-alone-in-early-spondyloarthritis/

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