Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 May 19:80:266-76.
doi: 10.12659/PJR.892529. eCollection 2015.

Diagnostics of Sacroiliitis According to ASAS Criteria: A Comparative Evaluation of Conventional Radiographs and MRI in Patients with a Clinical Suspicion of Spondyloarthropathy. Preliminary Results

Iwona Sudoł-Szopińska  1 , Brygida Kwiatkowska  2 , Monika Włodkowska-Korytkowska  1 , Genowefa Matuszewska  3 , Elżbieta Grochowska  3
Affiliations

Diagnostics of Sacroiliitis According to ASAS Criteria: A Comparative Evaluation of Conventional Radiographs and MRI in Patients with a Clinical Suspicion of Spondyloarthropathy. Preliminary Results

Iwona Sudoł-Szopińska et al. Pol J Radiol. .

Abstract

Background: The objective of this study was a comparative evaluation of radiography and MRI in the diagnostics of sacroiliitis in patients with a clinical diagnosis of spondyloartropathy, according to the current ASAS criteria.

Material/methods: Sacroiliac joints radiograms and MRI were conducted in 101 consecutive patients, aged 19-71 yrs (mean age: 40.6 yrs). The patients were referred by a senior rheumatologist, with symptoms of the chronic back pain. The sacroiliac joints were assessed on AP radiograms of the pelvis according to the modified New York criteria for ankylosing spondylitis. MRI was performed to look for active and chronic inflammatory lesions.

Results: Of 14 patients with radiographic sacroiliitis according to modified New York criteria, only 50% had sacroiliitis on MRI. The sensitivity and specificity of conventional radiography were 22% and 94% and of MRI were 71% and 90%. Cohen's kappa coefficient was κ=0.0187, agreement of radiograms and MRI was 58%. Among 86 patients displaying no sacroiliitis on radiograms, MRI showed sacroiliitis in 34 patients (39.5%). Positive predictive value was 0.429, negative predictive value was 0.605.

Conclusions: MRI allowed to diagnose sacroiliitis in 39,5 % of patients in preradiographic stage. MRI ruled out the presence of active inflammatory lesions in 60.4% of patients with sacroiliitis on radiograms according to modified New York criteria.

Keywords: Magnetic Resonance Imaging; Radiography; Sacroiliitis; Spondylarthropathies.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Bilateral sacroiliitis Grade I on radiograph (A); no active inflammatory lesions on MRI on T1 (B), T2 (C), and TIRM (D) sequencies, except for fatty infiltration of bone marrow in the right ilium and sacrium.
Figure 2
Figure 2
Bilateral sacroiliitis Grade 0 on radiograph (A); active sacroiliitis on MRI of the left SIJ, characterized by the presence of BME, and synovitis and active bone erosion in the left iliac bone on T1 (B), T2 (C), TIRM (D) and T1FSCE sequencies.
Figure 3
Figure 3
Sacroiliitis Grade I of the left SIJ on radiograph (A); bilateral active sacroiliitis on MRI, characterized by the presence of BME, erosions, synovitis on T1 (B), T2 (C), and TIRM (D) and T1FSCE (E) sequencies.
See this image and copyright information in PMC

References

    1. Sudoł-Szopińska I, Urbanik A. Diagnostic imaging of sacroiliac joint and the spine in the course of spondyloarthropathies. Pol J Radiol. 2013;78(2):43–49. - PMC - PubMed
    1. Lacout A, Rousselin B, Pelage J-P. CT and MRI of spine and sacroiliac involvement in spondyloartropathy. Am J Roentgenol. 2008;191:1016–23. - PubMed
    1. Sieper J, Rudwaleit M, Baraliakos X, et al. The assessment of Spondylo Artritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis. 2009;68(Suppl 2):ii1–44. - PubMed
    1. McMichael A, Bowness P. HLA-B27: natural function and pathogenic role in spondyloarthritis. Arthritis Res. 2002;4(Suppl,3):153–58. - PMC - PubMed
    1. Heuft-Dorenbosch L, Landewe R, Weijers R, et al. Performance of various criteria sets in patients with inflammatory back pain of short duration; the Maastricht early spondyloarthritis clinic. Ann Rheum Dis. 2007;66:92–98. - PMC - PubMed