Using an MRI to assess patients' spinal inflammation and diagnose axial spondyloarthritis may be unnecessary, according to a study published in Annals of the Rheumatic Diseases.
Here are five details:
1. The study comprised 541 and 650 participants with chronic back pain from the SPondyloArthritis Caught Early and the DEvenir Spondylarthropathies Indifférenciées Récentes cohorts. The participants were from Leiden University Medical Center in the Netherlands.
2. Researchers took an X-ray and MRI of the SI joints and a spinal MRI of each participant. Images were scored by at least more than two experienced central readers per modality in the SPACE and DESIR cohorts. Inflammation suggestive of axial spondyloarthritis was assessed in the entire spine, and a positive spinal MRI was defined by the presence of five or more inflammatory lesions.
3. Results from the 541 SPACE participants showed positive for sacroiliitis:
• 7 percent – on the SI joints X-ray
• 14 percent – on the SI joints MRI
• 1 percent – on the spinal MRI
4. Results from the 650 DESIR participants showed positive for sacroiliitis:
• 21 percent – on the SI joints X-ray
• 36 percent – on the SI joint MRI
• 7 percent – on the spinal MRI
5. Of the participants who didn't display sacroiliitis on imaging, 1 percent of SPACE and 2 percent of DESIR patients had a positive spine MRI.
Researchers concluded that adding a positive spinal MRI as imaging criterion only led to new classification in a total of one patient from each cohort, which is why the study authors do not recommend adding the spinal MRI to the Assessment of
SpondyloArthritis' International Society's classification criteria for axial spondyloarthritis.