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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.

arthritis and rheumatology

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