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Original Article

How sensitive and specific are MRI features of sacroiliitis for diagnosis of spondyloarthritis

Authors:

L Jans ,

Department of Radiology and Medical Imaging, University of Alberta Hospital, Edmonton, Alberta, Canada, CA
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L Coeman,

Department of Radiology and Medical Imaging, University of Alberta Hospital, Edmonton, Alberta, Canada, CA
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L Van Praet,

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium, BE
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P Carron,

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium, BE
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D Elewaut,

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium, BE
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F Van den Bosch,

Department of Rheumatology, Ghent University Hospital, Ghent, Belgium, BE
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JL Jaremko,

Department of Radiology, University of Alberta Hospital, Edmonton, Alberta, Canada, CA
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W Huysse,

Department of Radiology and Medical Imaging, University of Alberta Hospital, Edmonton, Alberta, Canada, CA
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KL Verstraete

Department of Radiology and Medical Imaging, University of Alberta Hospital, Edmonton, Alberta, Canada, CA
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Abstract

Objective: To determine the sensitivity and specificity of MRI features of sacroiliitis in spondyloarthritis (SpA).

Materials and methods: A retrospective study reviewed MRI of the sacroiliac (SI) joints in 517 patients with inflammatory back pain. Sensitivity, specificity, positive and negative likelihood ratios of active and structural lesions of sacroiliitis with final clinical diagnosis as golden standard was calculated.

Results: MRI showed active inflammation in 42% of patients (bone marrow oedema (BMO) (41.5%), capsulitis (3.3%), enthesitis (2.5%)) and structural changes in 48.8% of patients (erosion (25%), fat infiltration (31.6%), sclerosis (32%) and ankylosis (7.6%)). BMO was the MRI feature with the highest sensitivity (65.1%) for diagnosis of SpA. Capsulitis (99%), enthesitis (98.4%), ankylosis (97.4%) and erosion (94.8%) had a high specificity for diagnosis of SpA, whereas BMO (74.3%), sclerosis (75.8%) and fat infiltration (84.0%) were less specific. BMO concomitant with enthesitis, capsulitis or erosions increased the specificity. Concomitant presence of BMO and sclerosis or fat infiltration decreased the specificity.

Conclusion: BMO is moderately sensitive and specific for diagnosis of SpA in patients with inflammatory back pain. BMO concomitant with enthesitis, capsulitis, ankylosis or erosion increases the specificity. Concomitant fat infiltration or sclerosis decreases the specificity for diagnosis of SpA. Of all lesions, erosion had by far the highest positive likelihood ratio for diagnosis of SpA.

How to Cite: Jans, L. et al., (2014). How sensitive and specific are MRI features of sacroiliitis for diagnosis of spondyloarthritis. Journal of the Belgian Society of Radiology. 97(4), pp.202–205. DOI: http://doi.org/10.5334/jbr-btr.94
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Published on 01 Jul 2014.
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