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Prati C, Lequerre T, Le Goff B, Cortet B, Toumi H, Tournadre A, Marotte H, Lespessailles E. Novel insights into the anatomy and histopathology of the sacroiliac joint and correlations with imaging signs of sacroiliitis in case of axial spondyloarthritis. Front Physiol 2023; 14:1182902. [PMID: 37250138 PMCID: PMC10213906 DOI: 10.3389/fphys.2023.1182902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
For a better understanding of the pathophysiology of spondyloarthropathy (SpA), a detailed anatomical description of the sacroiliac joint is required because sacroiliitis is the earliest and most common sign of SpA and an essential feature for the diagnosis of ankylosing spondylitis. Beyond the anatomy, the histopathology of sacroiliac entheses and immunological mechanisms involved in sacroiliitis are crucial for a better understanding of disease causation. In this narrative review, we discuss the core anatomical, histological, and immunohistological observations involved in the development of sacroiliitis, focusing particularly on imaging-based information associated with sacroiliitis. Finally, we try to answer the question of whether at the sacroiliac joint, enthesitis precedes synovitis and subchondral bone changes in SpA.
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Affiliation(s)
- Clément Prati
- Department of Rheumatology, Besançon University Hospital, PEPITE EA4267, University of Franche-Comté, Besançon, France
| | - Thierry Lequerre
- Department of Rheumatology, Rouen University Hospital, Inserm 1234, CIC/CRB 1404, Rouen, France
| | - Benoît Le Goff
- Department of Rheumatology—CHU de Nantes, Nantes, France
| | - Bernard Cortet
- Department of Rheumatology, MABLAB ULR 4490, CHU Lille, University Lille, Lille, France
| | - Hechmi Toumi
- Department of Rheumatology, Translational Medicine Research Platform, PRIMMO, University Hospital Center of Orleans, Orleans, France
| | - Anne Tournadre
- Department of Rheumatology, CHU Clermont-Ferrand, UNH UMR1019 INRAE–Université Clermont Auvergne, Clermont-Ferrand, France
| | - Hubert Marotte
- Department of Rheumatology, University Hospital of Saint Etienne, INSERM, SAINBIOSE U1059, Saint-Etienne, France
| | - Eric Lespessailles
- Department of Rheumatology, Translational Medicine Research Platform, PRIMMO, University Hospital Center of Orleans, Orleans, France
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Hecquet S, Lustig JP, Verhoeven F, Chouk M, Aubry S, Wendling D, Prati C. Frequency and anatomic distribution of magnetic resonance imaging lesions in the sacroiliac joints of spondyloarthritis and non-spondyloarthritis patients. Ther Adv Musculoskelet Dis 2022; 14:1759720X221119245. [PMID: 36081745 PMCID: PMC9445526 DOI: 10.1177/1759720x221119245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background Lesions detected by magnetic resonance imaging (MRI) of the sacroiliac joints are critical to the diagnosis of non-radiographic axial spondyloarthritis. However, inflammatory and structural lesions may be encountered in other conditions. Objectives The objective of this study was to evaluate and compare the frequency and localization of inflammatory and structural lesions on MRIs of the sacroiliac joint of spondyloarthritis (SpA) and non-spondyloarthritis (non-SpA) patients. Design This is a retrospective study including 200 patients, each having undergone an MRI of the sacroiliac joints. Methods Two experienced readers evaluated the whole set of images to detect erosions, subchondral sclerosis, fatty lesions, bone marrow edema (BME) and ankylosis according to the definitions established by the ASAS MRI working group. We divided sacroiliac joints into five segments: upper, antero-middle, intermediate-middle, postero-middle and lower. Results A total of 96 subjects with SpA (mean age 37.4 ± 11.8 years) and 104 without SpA (mean age 39.9 ± 11.6 years) were included. Of the 96 SpA patients, 65% had inflammatory buttock pain compared with 25% in the non-SpA group. BME was seen in 65% of SpA patients, mainly in the intermediate-middle segment, and in 20% of non-SpA patients, predominantly in the antero-middle segment. Subchondral sclerosis occurred in 44% of non-SpA patients, mostly in the antero-middle segment, and in 36% of SpA patients. Fatty lesions were present in 34% of SpA and in 21% of non-SpA patients. Erosions were seen in 25% of non-SpA and in 60% of SpA patients. BME and structural lesions were minimally observed in the postero-middle segment in non-SpA patients. Conclusion Inflammatory and structural lesions were observed in all segments of the joint in SpA, mainly in the middle segments, while lesions predominantly affected the antero-middle segment in non-SpA, and were uncommon in the postero-middle segment.
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Affiliation(s)
- Sophie Hecquet
- Department of Rheumatology, CHU, 3 Boulevard Alexandre Fleming, 25000 Besançon, France
| | | | - Frank Verhoeven
- Department of Rheumatology, CHU, Besançon, France.,PEPITE EA4267, FHU INCREASE, Bourgogne Franche-Comté University, UFR Santé, Besançon, France
| | | | - Sébastien Aubry
- Department of Radiology, CHU, Besançon, France.,EA4662 Nanomedecine Laboratory, Bourgogne Franche-Comté University, UFR Santé, Besançon, France
| | - Daniel Wendling
- Department of Rheumatology, CHU, Besançon, France.,EPILAB EA 4266, Bourgogne Franche-Comté University, UFR Santé, Besançon, France
| | - Clément Prati
- Department of Rheumatology, CHU, Besançon, France.,PEPITE EA4267, FHU INCREASE, Bourgogne Franche-Comté University, UFR Santé, Besançon, France
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Ward MM, Yao L. Sacroiliac Bone Marrow Edema: Innocent Until Proven Guilty? Arthritis Rheumatol 2022; 74:1474-1476. [PMID: 35436388 PMCID: PMC9427687 DOI: 10.1002/art.42143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 03/21/2022] [Accepted: 04/12/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Michael M Ward
- Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Lawrence Yao
- Radiology and Imaging Sciences, NIH, Clinical Center, Bethesda, Maryland
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Giaconi J, Waldman L, Robinson J, Milanovic N, Weisman M, Learch T. Prevalence of sacroiliitis among patients referred for hip MR arthrography. Skeletal Radiol 2022; 51:795-799. [PMID: 34398309 DOI: 10.1007/s00256-021-03885-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/20/2021] [Accepted: 07/27/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the prevalence of sacroiliitis among patients who have been referred for MR arthrography. MATERIALS AND METHODS A retrospective search identified 130 consecutive MR arthrograms of the hip performed on a 1.5T Siemens Avanto at our institution from August 2013 to August 2014. Four studies were excluded due to the absence of a coronal short tau inversion recovery sequence of the pelvis, leaving 126 studies for analysis. A musculoskeletal radiology fellow and three attending musculoskeletal radiologists reviewed the images for the presence of bone marrow edema affecting the sacroiliac joints. Only cases of bone marrow edema meeting the Assessment of SpondyloArthritis international Society definition were considered positive. The two-tailed Fisher's exact test was used to compare the prevalence of positive MRI findings among age and gender groups. GraphPad InStat (GraphPad Software) was used for statistical calculations. RESULTS Patients less than 40 years of age demonstrated a statistically higher prevalence of positive MRI findings of sacroiliitis when compared to patients older than 40 (p = 0.0082). No difference in prevalence was found between genders. Overall prevalence of MRI signal alteration suggestive of sacroiliitis as defined by the Assessment of SpondyloArthritis international Society was 4.8%. Among the six patients with positive findings, two were subsequently diagnosed with spondyloarthritis. CONCLUSION Hip pain may be a presenting symptom of spondyloarthritis and attention should be paid to the sacroiliac joints during screening examinations, particularly in patients less than 40 years of age.
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Affiliation(s)
- Joseph Giaconi
- Department of Radiology, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
| | - Leah Waldman
- Department of Radiology, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA.
| | - Joseph Robinson
- Department of Radiology, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
| | - Nicholas Milanovic
- Department of Radiology, Essentia Health-St. Mary's Medical Center, 420 E. 1st St. Fl 1, Duluth, MN, 55805, USA
| | - Michael Weisman
- Department of Rheumatology, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
| | - Thomas Learch
- Department of Radiology, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA
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Nalli C, Manfredi L, Fredi M, Crisafulli F, Bertocchi S, Khizroeva J, Bitsadze V, Makatsariya A, Zatti S, Andreoli L, Franceschini F, Tincani A. Managing puerperium in patients with systemic autoimmune diseases: an update. Expert Rev Clin Immunol 2022; 18:391-399. [PMID: 35255770 DOI: 10.1080/1744666x.2022.2050216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Puerperium is a critical period for patients affected by autoimmune rheumatic diseases for the risk of disease's flares and difficulties in treating lactating mothers. We want to summarize the literature data about psychological and pharmacological management of these patients and possible risk factors of disease's flares. AREAS COVERED We made a narrative review on recent studies about puerperium in rheumatic autoimmune diseases patients. EXPERT OPINION The physicians involved in management of patients during puerperium and in the follow-up of babies need to agree on maternal treatment because they need to reassure mothers about the safety of the prescribed medications. Furthermore, women with rheumatic diseases could present some musculoskeletal limitations and psychological problems, such as postpartum depression, which can lead to a sense of inadequacy to the mother's task. Families and physicians should be aware of these possible complications and support the new mothers providing correct counseling and practical help.
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Affiliation(s)
- Cecilia Nalli
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Lucia Manfredi
- Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Micaela Fredi
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Francesca Crisafulli
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Stefania Bertocchi
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Jamilya Khizroeva
- Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Victoria Bitsadze
- Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Alexander Makatsariya
- Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Sonia Zatti
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Laura Andreoli
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Franco Franceschini
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Angela Tincani
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
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Kin-Hoo Koo K, Chinoy H, Creaney L, Hayton M. Inflammatory Arthropathy in the Elite Sports Athlete. Curr Sports Med Rep 2021; 20:577-583. [PMID: 34752430 DOI: 10.1249/jsr.0000000000000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Elite athletes commonly present with joint pains that are attributed to overuse injuries though on occasion it can be due to an inflammatory arthropathy. The diagnostic challenge is that presenting symptoms of benign injuries are similar to inflammatory arthropathies. A holistic review of the athlete can provide clues suggestive of inflammatory arthropathy, before requesting further investigations to confirm the diagnosis. Current imaging modalities are not specific in differentiating inflammatory arthritis with other causes of joint inflammation. Prompt treatment is required to restore the athlete to an optimum level of activity and prevent career ending disability, all in adherence to the regulations of the sporting governing bodies. This review aims to highlight the importance of inflammatory arthropathy in the differentials for an athlete presenting with joint pains.
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Affiliation(s)
- Kenneth Kin-Hoo Koo
- Department of Trauma and Orthopaedics, Salford Royal NHS Foundation Trust, Salford, UNITED KINGDOM
| | - Hector Chinoy
- National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, The University of Manchester, Manchester, UNITED KINGDOM
| | - Leon Creaney
- Manchester Institute of Health & Performance (MIHP), Manchester, UNITED KINGDOM
| | - Mike Hayton
- Upper Limb Unit, Wrightington Hospital, Hall Lane, Appley Bridge, Wrightington, Wigan, UNITED KINGDOM
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Lu CC, Huang GS, Lee TSH, Chao E, Chen HC, Guo YS, Chu SJ, Liu FC, Kao SY, Hou TY, Chen CH, Chang DM, Lyu SY. MRI contributes to accurate and early diagnosis of non-radiographic HLA-B27 negative axial spondyloarthritis. J Transl Med 2021; 19:298. [PMID: 34243762 PMCID: PMC8268359 DOI: 10.1186/s12967-021-02959-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 06/22/2021] [Indexed: 11/11/2022] Open
Abstract
Background Nonradiographic axial spondyloarthropathies (nr-axSpA) are diagnosed by the absence of radiographic sacroiliitis and the presence of bone marrow edema (BME) on magnetic resonance imaging (MRI). According to the classification criteria of the international Assessment of Spondyloarthritis Society (ASAS), structural changes to sacroiliac joints (SIJs) on MRI cannot be used as criteria in the absence of BME. However, less than half the Asian patients with clinically active axSpA show BME. The incidence of human leukocyte antigen (HLA)-B27 is low in Asian populations, which makes it more difficult to identify nr-axSpA. We used MRI to evaluate the structural damage to SIJs in patients with nr-axSpA with and without BME with the aim of identifying the best methodology for accurate diagnosis, especially in populations with less common BME and HLA-B27. Methods One hundred three patients with inflammatory back pain were included in this prospective study. No patient’s radiograph met the definition of positive modified New York criteria. BME and structural damage to SIJ including sclerosis and erosion were assessed independently on coronal and axial short-tau inversion recovery and T1-weighted spin echo MRI scans by two well-trained musculoskeletal radiologists using the Spondyloarthritis Research Consortium of Canada (SPARCC) score. Demographics of patients were collected. Disease characteristics and structural damage were analyzed in patients with and without BME on SIJ MRI. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of structural damage. Results All individuals in the cohort had at least one abnormal finding on SIJ MRI, including BME or structural damage; 36 of 103 patients had BME. We identified a significant positive correlation between SPARCC scores and severe erosion assessed by focal joint space widening (fJSW) (p = 0.001) in these 36 patients. Fifty-eight of the 103 enrolled patients fulfilled the ASAS criteria for nr-axSpA in the either absence or presence of BME. Of these 58 patients, 57 and 19 had erosions or fJSW, respectively, and the presence of BME was significantly correlated with fJSW (phi score of 0.319 and p = 0.015). We demonstrated a significant positive correlation between fJSW and either the presence or the severity of BME in patients with nr-axSpA who met the ASAS definition. There was a positive correlation between BME and fJSW across the whole study cohort (phi score of 0.389; p < 0.001). The area under the ROC curve (AUC) for fJSW on SIJ MRI was 0.736, p < 0.001. In both HLA-B27-positive and -negative groups, BME was more common in the presence of fJSW (phi scores of 0.370 and 0.377, p = 0.018 and 0.003, respectively) and SPARCC scores were higher in patients with fJSW (p < 0.001 and p = 0.005). We also identified a positive correlation between fJSW and BME in patients with nr-axSpA and normal serum levels of C-reactive protein (phi score of 0.362 and p = 0.001). Conclusion Structural damage detected on SIJ MRI, sclerosis, erosions and fJSW may be present in patients without detectable inflammation on SIJ MRI. However, fJSW is significantly correlated with the severity of inflammation seen on SIJ MRI, which contributes to the accurate diagnosis of nr-axSpA, and it could be used as an alternative diagnostic test for nr-axSpA in the general population, especially for those who do not carry the HLA-B27 gene, Asian patients without BME, or patients with normal serum inflammatory biomarkers.
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Affiliation(s)
- Chun-Chi Lu
- Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Pathology, University of Washington, Seattle, USA
| | - Guo-Shu Huang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, National Defense Medical Center, National Defense Medical Center, No. 100, Zhengrong St., Zhongzheng Dist, Keelung City, 202, Taiwan
| | - Tony Szu-Hsien Lee
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - En Chao
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan.,Tri-Service General Hospital Songshan Branch, Taipei, Taiwan
| | - Hsiang-Cheng Chen
- Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yong-Si Guo
- Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shi-Jye Chu
- Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Feng-Cheng Liu
- Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - San-Yuan Kao
- Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tsung-Yun Hou
- Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chen-Hung Chen
- Division of Rheumatology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Taipei, Taiwan
| | - Deh-Ming Chang
- Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Division of Allergy, Immunology, Rheumatology, Department of Internal Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
| | - Sin-Yi Lyu
- Division of Radiology, Tri-Service General Hospital, National Defense Medical Center, Keelung branch, Taipei, Taiwan.
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Imaging in Axial Spondyloarthritis: What is Relevant for Diagnosis in Daily Practice? Curr Rheumatol Rep 2021; 23:66. [PMID: 34218356 DOI: 10.1007/s11926-021-01030-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW To explore how imaging may assist diagnosing axial spondyloarthritis in rheumatology practice. RECENT FINDINGS A diagnosis of axial spondyloarthritis is based on pattern recognition by synthesizing clinical, laboratory, and imaging findings. In health care settings providing low threshold access to advanced imaging, sacroiliac joint MRI is the preferred imaging modality in clinically suspected axial spondyloarthritis. In daily routine, the optimum protocol to assess suspected inflammatory back pain combines sacroiliac joint and spine MRI fitting a 30-min slot. Contextual assessment of concomitant structural and active MRI lesions is key to enhance diagnostic utility. In women with postpartum back pain suggestive of axial spondyloarthritis, recent reports advocate waiting 6-12 months after delivery before acquiring sacroiliac joint MRI. Major unmet needs are consistent MRI protocols, standardized training modules on how to evaluate axial MRI, and timely dissemination of imaging advances into mainstream practice both in rheumatology and in radiology. In rheumatology practice, MRI has become indispensable to help diagnose early axial spondyloarthritis. However, major gaps in training and knowledge transfer to daily care need to be closed.
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Seven S, Østergaard M, Morsel-Carlsen L, Sørensen IJ, Bonde B, Thamsborg G, Lykkegaard JJ, Pedersen SJ. Morphological characteristics of sacroiliac joint MRI lesions in axial spondyloarthritis and control subjects. Rheumatology (Oxford) 2021; 61:1005-1017. [PMID: 34097000 DOI: 10.1093/rheumatology/keab468] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To investigate sacroiliac joint(SIJ) MRI inflammation, structural and degenerative lesion characteristics in patients with axial spondyloarthritis(axSpA) and various control groups. METHODS Patients with axSpA(n = 41) and lumbar disc herniation(n = 25), women with(n = 46) and without(n = 14) post-partum(childbirth within 4-16 months) buttock/pelvic pain, cleaning assistants(n = 26), long-distance runners(n = 23) and healthy men(n = 29) had MRI of the SIJs prospectively performed. MRI lesions were assessed on 9 slices covering the cartilaginous compartment by two experienced readers according to the definitions of the Spondyloarthritis Research Consortium of Canada(SPARCC) SIJ inflammation and structural scores, and were evaluated according to depth and extent. Other morphological characteristics were also analysed. RESULTS Total depth scores for bone marrow oedema(BME) and fat lesion(FAT) and total extent score for erosion were statistically significantly highest in axSpA, while scores for sclerosis were numerically highest in women with post-partum pain. Maximum BME depth > 10mm was frequently and exclusively found in axSpA and post-partum women(39% vs 14-17%) while FAT depth > 5mm was predominantly found in axSpA(76% vs 0-10%). Erosions were primarily seen in axSpA, especially when extensive(≥4 or confluent; 17% vs 0%). Capsulitis was absent in non-axSpA groups. BME and FAT in the ligamentous compartment were primarily found in axSpA(17/22% vs 0/2% in non-axSpA groups). In non-axSpA, osteophytes(axSpA vs non-axSpA: 0% vs 3-17%) and vacuum phenomenon(7% vs 30-66%) were more frequent, and the joint space was wider(mean(SD) 1.5(0.9)mm vs 2.2(0.5)mm). CONCLUSIONS FAT depth > 5mm, but not BME depth > 10mm, could almost differentiate axSpA patients from all other groups. When excluding post-partum women, BME >5mm and erosion were highly specific for axSpA.
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Affiliation(s)
- Sengül Seven
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Center of Head and Orthopedics, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Center of Head and Orthopedics, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Inge Juul Sørensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Center of Head and Orthopedics, Rigshospitalet, Glostrup, Denmark
| | - Birthe Bonde
- The Birthe Bonde Clinic of Physiotherapy, Copenhagen, Denmark
| | - Gorm Thamsborg
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Center of Head and Orthopedics, Rigshospitalet, Glostrup, Denmark
| | - Jens Jørgen Lykkegaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Center of Head and Orthopedics, Rigshospitalet, Glostrup, Denmark
| | - Susanne Juhl Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Center of Head and Orthopedics, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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10
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Seven S, Østergaard M, Morsel-Carlsen L, Sørensen IJ, Bonde B, Thamsborg G, Lykkegaard JJ, Pedersen SJ. Anatomic Distribution of Sacroiliac Joint Lesions on Magnetic Resonance Imaging in Patients With Axial Spondyloarthritis and Control Subjects: A Prospective Cross‐Sectional Study, Including Postpartum Women, Patients With Disc Herniation, Cleaning Staff, Runners, and Healthy Individuals. Arthritis Care Res (Hoboken) 2021; 73:742-754. [DOI: 10.1002/acr.24473] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/24/2020] [Indexed: 01/21/2023]
Affiliation(s)
- Sengül Seven
- Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Center of Head and Orthopedics, Rigshospitalet, Glostrup, and University of Copenhagen Copenhagen Denmark
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Center of Head and Orthopedics, Rigshospitalet, Glostrup, and University of Copenhagen Copenhagen Denmark
| | | | - Inge J. Sørensen
- Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Center of Head and Orthopedics Rigshospitalet Glostrup Denmark
| | - Birthe Bonde
- The Birthe Bonde Clinic of Physiotherapy Copenhagen Denmark
| | - Gorm Thamsborg
- Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Center of Head and Orthopedics Rigshospitalet Glostrup Denmark
| | - Jens J. Lykkegaard
- Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Center of Head and Orthopedics Rigshospitalet Glostrup Denmark
| | - Susanne J. Pedersen
- Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases Center of Head and Orthopedics, Rigshospitalet, Glostrup, and University of Copenhagen Copenhagen Denmark
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