Frequency of MRI changes suggestive of axial spondyloarthritis in the axial skeleton in a large population-based cohort of individuals aged <45 years

ObjectiveTo investigate the frequency of bone marrow oedema (BME) and fatty lesions (FL) suggestive of axial spondyloarthritis (axSpA) on MRI of the spine and sacroiliac joints (SIJ) in a general population sample.MethodsAs part of a community-based cohort project (Study of Health in Pomerania), vol...

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Veröffentlicht in:Annals of the rheumatic diseases Jg. 79; H. 2; S. 186 - 192
Hauptverfasser: Baraliakos, Xenofon, Richter, Adrian, Feldmann, Daniel, Ott, Anne, Buelow, Robin, Schmidt, Carsten O, Braun, Juergen
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Elsevier Limited 01.02.2020
Schlagworte:
Adult
Age
Arthritis
Axial skeleton
Back pain
Bone marrow
Bone Marrow Diseases - diagnostic imaging
Classification
Cohort Studies
Design
Edema
Edema - diagnostic imaging
Female
Humans
Inflammation
Inflammatory diseases
Joint diseases
Lesions
Magnetic resonance imaging
Magnetic Resonance Imaging - statistics & numerical data
Male
Mechanical properties
Participation
Patients
Population
Population studies
Rheumatic diseases
Sacroiliac Joint - diagnostic imaging
Sensitivity and Specificity
Skeleton
Spine
Spine - diagnostic imaging
Spondylarthritis - diagnostic imaging
Studies
Trends
Vertebrae
Germany
spondyloarthritis
MRI
ankylosing spondylitis
ISSN:0003-4967, 1468-2060, 1468-2060
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Zusammenfassung:ObjectiveTo investigate the frequency of bone marrow oedema (BME) and fatty lesions (FL) suggestive of axial spondyloarthritis (axSpA) on MRI of the spine and sacroiliac joints (SIJ) in a general population sample.MethodsAs part of a community-based cohort project (Study of Health in Pomerania), volunteers underwent spinal (sagittal T1/T2) and SIJ (semicoronal short tau inversion recovery) MRI examinations. Two calibrated readers evaluated the images to detect BME in SIJ and vertebral corners (VC) and FL in VC suggestive of axSpA using Assessment of SpondyloArthritis international Society definitions.ResultsMRIs of 793 volunteers (49.4% males, mean age 37.3±6.3 years, 8.4% human leucocyte antigen-B27+) aged <45 years were evaluated. SIJ BME was seen in 136 (17.2%), VC BME in 218 (27.5%) and FL in 645 (81.4%) volunteers. SIJ BME in ≥1, ≥3 and ≥5 SIJ quadrants was seen in 136 (17.2%), 7 (0.9%) and 1 (0.1%) volunteers, respectively. In VC, BME≥1, ≥3 and ≥5 lesions were seen in 218 (27.5%), 38 (4.8%) and 6 (0.8%) volunteers, respectively, while FL≥1, ≥3 and ≥5 were seen in 645 (81.3%), 351 (44.3%) and 185 (23.3%) volunteers, respectively. Logistic regression analysis showed that BME and FL in VC were related to increasing age: OR 1.33, 95% CI 1.02 to 1.72, and OR 1.73, 95% CI 1.32 to 2.27, per decade increase, respectively.ConclusionsIn this large population-based study, a high frequency of inflammatory and fatty MRI lesions suggestive of axSpA was found, especially in the spine. This indicates a limited value of such MRI findings for diagnosis and classification of axSpA. The increasing frequency with age suggests that mechanical factors could play a role.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0003-4967
1468-2060
1468-2060
DOI:10.1136/annrheumdis-2019-215553