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Magnetic Resonance Imaging of the Sacroiliac Joints Indicating Sacroiliitis According to the Assessment of SpondyloArthritis international Society Definition in Healthy Individuals, Runners, and Women With Postpartum Back Pain
Author(s) -
Winter Janneke,
Hooge Manouk,
Sande Marleen,
Jong Henriëtte,
Hoeven Lonneke,
Koning Anoek,
Berg Inger Jorid,
Ramonda Roberta,
Baeten Dominique,
Heijde Désirée,
Weel Angelique,
Landewé Robert
Publication year - 2018
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.40475
Subject(s) - sacroiliitis , medicine , magnetic resonance imaging , sacroiliac joint , back pain , physical therapy , cohort , low back pain , axial spondyloarthritis , radiology , pathology , alternative medicine
Objective To compare magnetic resonance images ( MRI s) of the sacroiliac ( SI ) joints of healthy subjects and individuals with known mechanical strain acting upon the SI joints to those of patients with axial spondyloarthritis (SpA) and patients with chronic back pain. Methods Three readers who had received standardized training and were blinded with regard to study group randomly scored MRI s of the SI joints of 172 subjects, including 47 healthy individuals without current or past back pain, 47 axial SpA patients from the Spondyloarthritis Caught Early ( SPACE ) cohort (with a previous MRI confirmed positive for sacroiliitis), 47 controls with chronic back pain (irrespective of MRI results) from the SPACE cohort, 7 women with postpartum back pain, and 24 frequent runners. MRI s were scored according to the Assessment of SpondyloArthritis international Society ( ASAS ) definition and Spondyloarthritis Research Consortium of Canada ( SPARCC ) index. Results Of the 47 healthy volunteers, 11 (23.4%) had an MRI positive for sacroiliitis, compared to 43 (91.5%) of 47 axial SpA patients and 3 (6.4%) of 47 patients with chronic back pain. Three (12.5%) of the 24 runners and 4 (57.1%) of the 7 women with postpartum back pain had a positive MRI . Using a SPARCC cutoff of ≥2 for positivity, 12 (25.5%) of 47 healthy volunteers, 46 (97.9%) of 47 positive axial SpA patients, 5 (10.6%) of 47 controls with chronic back pain, 4 (16.7%) of 24 runners, and 4 (57.1%) of 7 women with postpartum back pain had positive MRI s. Deep bone marrow edema ( BME ) lesions were not found in healthy volunteers, patients with chronic back pain, or runners, but were found in 42 (89.4%) of 47 positive axial SpA patients and in 1 (14.3%) of 7 women with postpartum back pain. Conclusion A substantial proportion of healthy individuals without current or past back pain has an MRI positive for sacroiliitis according to the ASAS definition. Deep (extensive) BME lesions are almost exclusively found in axial SpA patients.