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Krabbe S, Møller JM, Hadsbjerg AEF, Ewald A, Hangaard S, Pedersen SJ, Østergaard M. Detection of structural lesions of the sacroiliac joints in patients with spondyloarthritis: A comparison of T1-weighted 3D spoiled gradient echo MRI and MRI-based synthetic CT versus T1-weighted turbo spin echo MRI. Skeletal Radiol 2024:10.1007/s00256-024-04669-5. [PMID: 38592521 DOI: 10.1007/s00256-024-04669-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/24/2024] [Accepted: 03/24/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES To investigate the detection of erosion, sclerosis and ankylosis using 1 mm 3D T1-weighted spoiled gradient echo (T1w-GRE) MRI and 1 mm MRI-based synthetic CT (sCT), compared with conventional 4 mm T1w-TSE. MATERIALS AND METHODS Prospective, cross-sectional study. Semi-coronal 4 mm T1w-TSE and axial T1w-GRE with 1.6 mm slice thickness and 0.8 mm spacing between overlapping slices were performed. The T1w-GRE images were processed into sCT images using a commercial deep learning algorithm, BoneMRI. Both were reconstructed into 1 mm semi-coronal images. T1w-TSE, T1w-GRE and sCT images were assessed independently by 3 expert and 4 non-expert readers for erosion, sclerosis and ankylosis. Cohen's kappa for inter-reader agreement, exact McNemar test for lesion frequencies and Wilcoxon signed-rank test for confidence in lesion detection were used. RESULTS Nineteen patients with axial spondyloarthritis were evaluated. T1w-GRE increased inter-reader agreement for detecting erosion (kappa 0.42 vs 0.21 in non-experts), increased detection of erosion (57 vs 43 of 152 joint quadrants) and sclerosis (26 vs 17 of 152 joint quadrants) among experts, and increased reader confidence for scoring erosion and sclerosis. sCT increased inter-reader agreement for detecting sclerosis (kappa 0.69 vs 0.37 in experts) and ankylosis (0.71 vs 0.52 in non-experts), increased detection of sclerosis (34 vs 17 of 152 joint quadrants) and ankylosis (20 vs 13 of 76 joint halves) among experts, and increased reader confidence for scoring erosion, sclerosis and ankylosis. CONCLUSION T1w-GRE and sCT increase sensitivity and reader confidence for the detection of erosion, sclerosis and ankylosis, compared with T1w-TSE. CLINICAL RELEVANCE STATEMENT These methods improve the detection of sacroiliac joint structural lesions and might be a useful addition to SIJ MRI protocols both in routine clinical care and as structural outcome measures in clinical trials.
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Affiliation(s)
- Simon Krabbe
- Department of Radiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.
- Copenhagen Center for Arthritis Research, Rigshospitalet, Valdemar Hansens Vej 1-27, 2600, Glostrup, Denmark.
| | - Jakob M Møller
- Department of Radiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark
| | - Anna E F Hadsbjerg
- Copenhagen Center for Arthritis Research, Rigshospitalet, Valdemar Hansens Vej 1-27, 2600, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Anne Ewald
- Department of Radiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark
| | - Stine Hangaard
- Department of Radiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Rigshospitalet, Valdemar Hansens Vej 1-27, 2600, Glostrup, Denmark
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Rigshospitalet, Valdemar Hansens Vej 1-27, 2600, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
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Østergaard M, Wetterslev M, Hadsbjerg AE, Maksymowych WP, Eshed I, Jans L, Emad Y, Pedersen SJ, Stoenoiu MS, Bird P, Foltz V, Mathew AJ, Paschke J, Carron P, De Marco G, Marzo-Ortega H, Møller-Bisgaard S, Conaghan PG, Lambert RG. The OMERACT whole-body MRI scoring system for inflammation in peripheral joints and entheses (WIPE) in spondyloarthritis - reference image atlas for the knee region. Semin Arthritis Rheum 2024; 65:152384. [PMID: 38325053 DOI: 10.1016/j.semarthrit.2024.152384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To develop a reference image atlas for the Outcome Measures in Rheumatology whole-body MRI scoring system for inflammation in peripheral joints and entheses (OMERACT MRI-WIPE) of the knee region. METHODS Image examples of each pathology, location and grade, were collected and discussed at web-based, interactive meetings within the OMERACT MRI in Arthritis Working Group. Subsequently, reference images were selected by consensus. RESULTS Reference images for each grade, pathology and location are depicted, along with definitions, reader rules and recommended MRI-sequences. CONCLUSION The atlas guides scoring whole-body MRIs for inflammation in joints and entheses of the knee region according to MRI-WIPE methodology in clinical trials and cohorts.
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Affiliation(s)
- Mikkel Østergaard
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Marie Wetterslev
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
| | - Anna Ef Hadsbjerg
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Walter P Maksymowych
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; CARE Arthritis, Edmonton, Alberta, Canada
| | - Iris Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the School of Medicine, Tel-Aviv University, Israel
| | - Lennart Jans
- Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - Yasser Emad
- Department of Rheumatology, Faculty of Medicine, Cairo University, Egypt
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
| | - Maria S Stoenoiu
- Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Experimentale et Clinique, Université Catholique de Louvain, Bruxelles, Belgium
| | - Paul Bird
- Division of Medicine, University of New South Wales, Sydney, Australia
| | - Violaine Foltz
- Department of Rheumatology, Sorbonne University, APHP, Pitié-Salpètrière Hospital, Paris, France
| | - Ashish J Mathew
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark; Department of Clinical Immunology & Rheumatology, Christian Medical College, Vellore, India
| | | | - Philippe Carron
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; VIB Inflammation Research Centre, Ghent University, Ghent, Belgium
| | - Gabriele De Marco
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Helena Marzo-Ortega
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Signe Møller-Bisgaard
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Robert Gw Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
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Østergaard M, Lambert RG, Hadsbjerg AE, Eshed I, Maksymowych WP, Mathew AJ, Jans L, Pedersen SJ, Carron P, Emad Y, De Marco G, Bird P, Stoenoiu MS, Foltz V, Paschke J, Marzo-Ortega H, Møller-Bisgaard S, Conaghan PG, Wetterslev M. Hip and pelvis region MRI reference image atlas for scoring inflammation in peripheral joints and entheses according to the OMERACT-MRI WIPE scoring system in patients with spondyloarthritis. Semin Arthritis Rheum 2024; 65:152383. [PMID: 38325055 DOI: 10.1016/j.semarthrit.2024.152383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To develop a reference image atlas for scoring the hip/pelvis region according to the OMERACT whole-body MRI scoring system for inflammation in peripheral joints and entheses (MRI-WIPE). METHODS We collected image examples of each pathology, location and grade, discussed them at web-based, interactive meetings and, finally, selected reference images by consensus. RESULTS Reference images for each grade and location of osteitis, synovitis and soft tissue inflammation are provided, as are definitions, reader rules and recommended MRI-sequences. CONCLUSION A reference image atlas was created to guide scoring whole-body MRIs for arthritis and enthesitis in the hip/pelvis region in spondyloarthritis/psoriatic arthritis clinical trials and cohorts.
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Affiliation(s)
- Mikkel Østergaard
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Robert Gw Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Anna Ef Hadsbjerg
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Iris Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the School of Medicine, Tel-Aviv University, Israel
| | - Walter P Maksymowych
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; CARE Arthritis, Edmonton, Alberta, Canada
| | - Ashish J Mathew
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark; Department of Clinical Immunology & Rheumatology, Christian Medical College, Vellore, India
| | - Lennart Jans
- Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
| | - Philippe Carron
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; VIB Inflammation Research Centre, Ghent University, Ghent, Belgium
| | - Yasser Emad
- Department of Rheumatology, Faculty of Medicine, Cairo University, Egypt
| | - Gabriele De Marco
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Paul Bird
- Division of Medicine, University of New South Wales, Sydney, Australia
| | - Maria S Stoenoiu
- Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Experimentale et Clinique, Université Catholique de Louvain, Bruxelles, Belgium
| | - Violaine Foltz
- Department of Rheumatology, Sorbonne University, APHP, Pitié-Salpètrière Hospital, Paris, France
| | | | - Helena Marzo-Ortega
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Signe Møller-Bisgaard
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Marie Wetterslev
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
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Port H, Christiansen F, Nielsen SH, Frederiksen P, Bay-Jensen AC, Karsdal MA, Seven S, Sørensen IJ, Loft AG, Madsen OR, Ostergaard M, Pedersen SJ. Identification of patient endotypes and adalimumab treatment responders in axial spondyloarthritis using blood-derived extracellular matrix biomarkers. RMD Open 2024; 10:e003769. [PMID: 38199849 PMCID: PMC10806480 DOI: 10.1136/rmdopen-2023-003769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE To explore the potential of a panel of ECM remodelling markers as endotyping tools for axial spondyloarthritis (axSpA) by separating patients into subtypes and investigate how they differ among each other in disease activity scores and response to treatment with adalimumab. METHODS In three axSpA studies, a panel of 14 blood-based ECM biomarkers related to formation of collagen (PRO-C2, PRO-C3, PRO-C6), degradation of collagen by metalloproteinases (C1M, C2M, T2CM, C3M, C4M, C6M, C10C), matrix metalloproteinase (MMP)-degraded prolargin (PROM), MMP-degraded and citrullinated vimentin (VICM), basement membrane turnover (PRO-C4) and neutrophil activity (CPa9-HNE) were assessed to enable patient clustering (endotyping). MASH (n=41) was a cross-sectional study, while Adalimumab in Axial Spondyloarthritis study (ASIM,n=45) and Danish Multicenter Study of Adalimumab in Spondyloarthritis (DANISH, n=49) were randomised, double-blind placebo-controlled trials of adalimumab versus placebo every other week for 6 or 12 weeks, respectively, followed by active treatment. Biomarker data were log-transformed, standardised by mean centering and scaled by the SD prior to principal component analysis and K-means clustering. RESULTS Based on all three studies, we identified two orthogonal dimensions reflecting: (1) inflammation and neutrophil activity (driven by C1M and CPa9-HNE) and (2) collagen turnover (driven by PRO-C2). Three endotypes were identified: high inflammation endotype (Endotype1), low inflammation endotype (Endotype 2) and high collagen turnover endotype (Endotype3). Endotype1 showed higher disease activity (Ankylosing Spondylitis Disease Activity Score (ASDAS)) at baseline compared with Endotype2 and Endotype3 and higher percentage of patients responding to adalimumab based on ASDAS clinical improvement at week 24. Endotype3 showed higher percentage of patients with 50% improvement in Bath Ankylosing Spondylitis Disease Activity Index response at week 24 compared with Endotype2. CONCLUSION These endotypes differ in their tissue remodelling profile and may in the future have utility for patient stratification and treatment tailoring.
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Affiliation(s)
- Helena Port
- Department of Clinical Medicine, Copenhagen University Hospital, Kobenhavn, Denmark
- Nordic Bioscience, Herlev, Denmark
| | | | | | | | | | | | - Sengul Seven
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Gentofte and Frederiksberg, Denmark
| | - Inge Juul Sørensen
- Department of Clinical Medicine, Copenhagen University Hospital, Kobenhavn, Denmark
- Department of Rheumatology and Spine diseases, Righospitalet, Copenhagen, Denmark
| | - Anne Gitte Loft
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Rintek Madsen
- Department of Clinical Medicine, Copenhagen University Hospital, Kobenhavn, Denmark
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Gentofte and Frederiksberg, Denmark
- Department of Rheumatology and Spine diseases, Righospitalet, Copenhagen, Denmark
| | - Mikkel Ostergaard
- Department of Clinical Medicine, Copenhagen University Hospital, Kobenhavn, Denmark
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Gentofte and Frederiksberg, Denmark
- Department of Rheumatology and Spine diseases, Righospitalet, Copenhagen, Denmark
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Gentofte and Frederiksberg, Denmark
- Department of Rheumatology and Spine diseases, Righospitalet, Copenhagen, Denmark
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Maksymowych WP, Jaremko JL, Pedersen SJ, Eshed I, Weber U, McReynolds A, Bird P, Wichuk S, Lambert RG. Comparative validation of the knee inflammation MRI scoring system and the MRI osteoarthritis knee score for semi-quantitative assessment of bone marrow lesions and synovitis-effusion in osteoarthritis: an international multi-reader exercise. Ther Adv Musculoskelet Dis 2023; 15:1759720X231171766. [PMID: 37457557 PMCID: PMC10345937 DOI: 10.1177/1759720x231171766] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 04/05/2023] [Indexed: 07/18/2023] Open
Abstract
Background Bone marrow lesions (BMLs) and synovitis on magnetic resonance imaging (MRI) are associated with symptoms and predict degeneration of articular cartilage in osteoarthritis (OA). Validated methods for their semiquantitative assessment on MRI are available, but they all have similar scoring designs and questionable sensitivity to change. New scoring methods with completely different designs need to be developed and compared to existing methods. Objectives To compare the performance of new web-based versions of the Knee Inflammation MRI Scoring System (KIMRISS) with the MRI OA Knee Score (MOAKS) for quantification of BMLs and synovitis-effusion (S-E). Design Retrospective follow-up cohort. Methods We designed web-based overlays outlining regions in the knee that are scored for BML in MOAKS and KIMRISS. For KIMRISS, both BML and S-E are scored on consecutive sagittal slices. The performance of these methods was compared in an international reading exercise of 8 readers evaluating 60 pairs of scans conducted 1 year apart from cases recruited to the OA Initiative (OAI) cohort. Interobserver reliability for baseline status and baseline to 1 year change in BML and S-E was assessed by intra-class correlation coefficient (ICC) and smallest detectable change (SDC). Feasibility was assessed using the System Usability Scale (SUS). Results Mean change in BML and S-E was minimal over 1 year. Pre-specified targets for acceptable reliability (ICC ⩾ 0.80 and ⩾ 0.70 for status and change scores, respectively) were achieved more frequently for KIMRISS for both BML and synovitis. Mean (95% CI) ICC for change in BML was 0.88 (0.83-0.92) and 0.69 (0.60-0.78) for KIMRISS and MOAKS, respectively. KIMRISS mean SUS usability score was 85.7 and at the 95th centile of ranking for usability versus a score of 55.4 and 20th centile for MOAKS. Conclusion KIMRISS had superior performance metrics to MOAKS for quantification of BML and S-E. Both methods should be further compared in trials of new therapies for OA.
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Affiliation(s)
| | - Jacob L. Jaremko
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
- Medical Imaging Consultants, Edmonton, AB, Canada
| | - Susanne J. Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Iris Eshed
- Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | | | - Andrew McReynolds
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB, Canada
| | - Paul Bird
- Division of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Stephanie Wichuk
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Robert G. Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
- Medical Imaging Consultants, Edmonton, AB, Canada
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Møller JM, Andreasen CM, Buus TW, Pedersen SJ, Østergaard M, Thomsen HS, Jurik AG. Diffusion-weighted MR imaging in chronic non-bacterial osteitis: Proof-of-concept of the apparent diffusion coefficient as an outcome measure. Acta Radiol Open 2021; 10:20584601211044478. [PMID: 34616565 PMCID: PMC8489758 DOI: 10.1177/20584601211044478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 08/19/2021] [Indexed: 11/16/2022] Open
Abstract
Background The apparent diffusion coefficient (ADC), as determined by whole-body diffusion-weighted MRI, may be useful as an outcome measure for monitoring response to treatment in chronic non-bacterial osteitis. Purpose To test and demonstrate the feasibility of ADC-measurement methods for use as outcome measure in chronic non-bacterial osteitis. Materials and Methods Using data from a randomized pilot study, feasibility of change-score ADC between baseline and second MRI (ΔADC12) and third MRI (ΔADC13) as outcome measure was assessed in three settings: “whole-lesion,” “single-slice per lesion,” and “index-lesion per patient”. Bone marrow edema lesions were depicted on short tau inversion recovery sequence at baseline and copied to ADC maps at the three time-points. Correlations between the three settings were measured as were analysis of variances. Discriminant validity was assessed as inter- and intra-observer reproducibility and smallest detectable change. Results 12 subjects were enrolled, and MRI was performed at baseline and weeks 12 and 36. Pearson correlation was high (r > 0.86; p ≤ 0.01) for ΔADC between single-slice—whole-lesion and whole-lesion—index-lesion and tended to be significant for single-slice—index-lesion settings (p = 0.06). For ΔADC12 and ΔADC13, Bland–Altman plots showed small differences (0.02, 0.03) and narrow 95% limits-of-agreement (−0.13–0.09, −0.07–0.05 μm2/s) between whole-lesion and single-slice ROI settings. Inter-observer reproducibility measured by intra-class correlation coefficient was poor-to-fair (range: 0.09–0.31), whereas intra-observer reproducibility was good-to-excellent (range: 0.67–0.90). Smallest detectable changes were between 0.21–0.28 μm2/s. Conclusion ADC change-score as outcome measure was feasible, and the single-slice per lesion ROI setting performed almost equally to whole-lesion setting resulting in reduced assessment time.
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Affiliation(s)
- Jakob M Møller
- Department of Radiology, Herlev-Gentofte Hospital, Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Caroline M Andreasen
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Medicine, Rheumatology, Vejle Hospital, Vejle, Denmark
| | - Thomas W Buus
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - Mikkel Østergaard
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - Henrik S Thomsen
- Department of Radiology, Herlev-Gentofte Hospital, Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne G Jurik
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
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Wetterslev M, Maksymowych WP, Lambert RG, Eshed I, Pedersen SJ, Stoenoiu MS, Krabbe S, Bird P, Foltz V, Mathew AJ, Gandjbakhch F, Paschke J, Carron P, De Marco G, Marzo-Ortega H, Poulsen AE, Jaremko JL, Conaghan PG, Østergaard M. Joint and entheseal inflammation in the knee region in spondyloarthritis - reliability and responsiveness of two OMERACT whole-body MRI scores. Semin Arthritis Rheum 2021; 51:933-939. [PMID: 34176643 DOI: 10.1016/j.semarthrit.2021.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/19/2021] [Accepted: 05/31/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To perform region-based development of whole-body MRI through validation of knee region scoring systems in spondyloarthritis (SpA). METHODS Assessment of knee inflammatory pathologies using 2 systems, OMERACT MRI Whole-body score for Inflammation in Peripheral joints and Entheses (MRI-WIPE) and Knee Inflammation MRI Scoring System (KIMRISS), in 4 iterative multi-reader exercises. RESULTS In the final exercise, reliability was mostly good for readers with highest agreement in previous exercise. Median pairwise single-measure ICCs for osteitis and synovitis/effusion status/change were 0.71/0.48 (WIPE-osteitis), 0.48/0.77 (WIPE-synovitis/effusion), 0.59/0.91 (KIMRISS-osteitis) and 0.92/0.97 (KIMRISS-synovitis/effusion). SRMs were 0.74 (WIPE-synovitis/effusion) and 0.78 (KIMRISS-synovitis/effusion). CONCLUSION MRI-WIPE and KIMRISS may both be useful in SpA whole-body evaluation studies.
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Affiliation(s)
- Marie Wetterslev
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Walter P Maksymowych
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; CARE Arthritis, Edmonton, Alberta, Canada
| | - Robert Gw Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada; Medical Imaging Consultants, Edmonton, Alberta, Canada
| | - Iris Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Israel
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen, Denmark
| | - Maria S Stoenoiu
- Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Bruxelles, Belgium
| | - Simon Krabbe
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen, Denmark
| | - Paul Bird
- Division of Medicine, University of New South Wales, Sydney, Australia
| | - Violaine Foltz
- Department of Rheumatology, Sorbonne University, APHP, Pitié-Salpêtrière Hospital, Paris, France
| | - Ashish J Mathew
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Frédérique Gandjbakhch
- Department of Rheumatology, Sorbonne University, APHP, Pitié-Salpêtrière Hospital, Paris, France
| | | | - Philippe Carron
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; VIB Inflammation Research Centre, Ghent University, Ghent, Belgium
| | - Gabriele De Marco
- Leeds Institute of Rheumatic and Musculoskeletal medicine, University of Leeds, Leeds, UK; Leeds Teaching Hospitals NHS Trust, NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Helena Marzo-Ortega
- Leeds Institute of Rheumatic and Musculoskeletal medicine, University of Leeds, Leeds, UK; Leeds Teaching Hospitals NHS Trust, NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Anna Ef Poulsen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen, Denmark
| | - Jacob L Jaremko
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal medicine, University of Leeds, Leeds, UK; Leeds Teaching Hospitals NHS Trust, NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Maksymowych WP, McReynolds A, Pedersen SJ, Weber U, Paschke J, Wichuk S, Jaremko JL, Lambert RG. The OMERACT Knee Inflammation MRI Scoring System: Validation of quantitative methodologies and tri-compartmental overlays in osteoarthritis. Semin Arthritis Rheum 2021; 51:925-928. [PMID: 34167825 DOI: 10.1016/j.semarthrit.2021.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/12/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To validate a revised version of the KIMRISS method for quantification of BML and synovitis-effusion in the knee by comparison with an established method, MOAKS. METHODS Novel calibration tools were developed for both methods. We compared reliability for status and change scores of BML and synovitis-effusion on baseline and one-year MRI scans. RESULTS Significant increase in both BML and synovitis-effusion was evident using KIMRISS but only for synovitis-effusion using MOAKS. Pre-specified targets for acceptable reliability (≥0.80 and ≥0.70 for status and change scores, respectively) were achieved more frequently for KIMRISS for both BML and synovitis. CONCLUSION Per OFISA criteria, KIMRISS should progress to assessment of discrimination.
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Affiliation(s)
- Walter P Maksymowych
- Department of Medicine, University of Alberta, 13-103 Clinical Sciences Building, 11350-83 Avenue, Edmonton T6G 2G3, Alberta, Canada; CARE Arthritis, CARE Arthritis Ltd. 316 Windermere Road NW Unit 210, Edmonton T6W 2Z8, Alberta, Canada.
| | - Andrew McReynolds
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, 2A2.41 WC Mackenzie Health Sciences Centre, 8440 112 Street NW, T6G 2B7, Medical Imaging Consultants, 202-11010 - 101 Street NW, T5H 4B9, Edmonton, Alberta, Canada
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansen Vej 17, 2600 Glostrup, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | | | - Joel Paschke
- CARE Arthritis, CARE Arthritis Ltd. 316 Windermere Road NW Unit 210, Edmonton T6W 2Z8, Alberta, Canada
| | - Stephanie Wichuk
- Department of Medicine, University of Alberta, 13-103 Clinical Sciences Building, 11350-83 Avenue, Edmonton T6G 2G3, Alberta, Canada
| | - Jacob L Jaremko
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, 2A2.41 WC Mackenzie Health Sciences Centre, 8440 112 Street NW, T6G 2B7, Medical Imaging Consultants, 202-11010 - 101 Street NW, T5H 4B9, Edmonton, Alberta, Canada
| | - Robert G Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, 2A2.41 WC Mackenzie Health Sciences Centre, 8440 112 Street NW, T6G 2B7, Medical Imaging Consultants, 202-11010 - 101 Street NW, T5H 4B9, Edmonton, Alberta, Canada
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Maugesten Ø, Pedersen SJ, Stoenoiu MS, Kroon F, Mathew AJ, Genant HK, Conaghan PG, Gandjbakhch F, Kloppenburg M, Peterfy C, Østergaard M, Haugen IK. Reliability and agreement of proton density-weighted vs. gadolinium-enhanced T1-weighted MRI in hand osteoarthritis. An OMERACT MRI special interest group reliability exercise. Semin Arthritis Rheum 2021; 51:929-932. [PMID: 34140182 DOI: 10.1016/j.semarthrit.2021.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To compare reliabilities of assessing synovitis in hand osteoarthritis (OA) using Magnetic Resonance Imaging (MRI) with/without gadolinium (Gd). METHODS Three readers scored synovitis on non-enhanced two-dimensional (2D) proton density (PD)-weighted MRI and Gd-enhanced (3D) MRI of hand joints in 20 patients. Inter-reader reliabilities were examined. RESULTS Reliability was good for Gd-enhanced MRI, but poor for non-enhanced PD-weighted MRI (intraclass correlation coefficient 0.83 and 0.21, respectively). Agreement between the two sequences was poor (weighted kappa 0.18). CONCLUSION Gd-enhanced MRI was more reliable than PD-weighted MRI for assessing synovitis. Gd-enhancement, but also resolution and tissue contrast, might have contributed to this.
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Affiliation(s)
- Ø Maugesten
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Box 23 Vinderen, Oslo N-0319, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - S J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
| | - M S Stoenoiu
- Department of Rheumatology, Cliniques Universitaires Saint Luc, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Belgium
| | - Fpb Kroon
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands; Department of Rheumatology, Zuyderland Medical Center, Heerlen, the Netherlands
| | - A J Mathew
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
| | - H K Genant
- Department of radiology and biomedical imaging, University of California, San Francisco, United States
| | - P G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - F Gandjbakhch
- Department of Rheumatology, Sorbonne University, APHP, Pitié-Salpêtrière Hospital, Paris, France
| | - M Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
| | - C Peterfy
- Spire Sciences, Inc., Boca Raton, FL 33487, United States
| | - M Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
| | - I K Haugen
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Box 23 Vinderen, Oslo N-0319, Norway
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Wetterslev M, Lambert RG, Maksymowych WP, Eshed I, Pedersen SJ, Bird P, Stoenoiu MS, Krabbe S, Mathew AJ, Foltz V, Gandjbakhch F, Paschke J, De Marco G, Marzo-Ortega H, Carron P, Poulsen AE, Jaremko JL, Conaghan PG, Østergaard M. Arthritis and enthesitis in the hip and pelvis region in spondyloarthritis - OMERACT validation of two whole-body MRI methods. Semin Arthritis Rheum 2021; 51:940-945. [PMID: 34140185 DOI: 10.1016/j.semarthrit.2021.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/09/2021] [Accepted: 05/13/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To validate reliability, correlation and responsiveness of two whole-body MRI scores for the hip/pelvis region in spondyloarthritis. METHODS Assessment of hip/pelvis inflammation in 4 multi-reader exercises using the OMERACT MRI Whole-body score for Inflammation in Peripheral joints and Entheses (MRI-WIPE) and Hip Inflammation Magnetic Resonance Imaging Scoring System (HIMRISS). RESULTS In exercises 3-4 (11/20 cases, respectively; 9 readers) reliability was mostly good for the 3 best calibrated readers. Median pairwise single-measure ICC for status were 0.58-0.65 (WIPE-osteitis), 0.10-0.88 (HIMRISS-osteitis) and for status/change 0.38-0.72/0.52-0.60 (WIPE-synovitis/effusion) and 0.68-0.89/0.78-0.85 (HIMRISS-synovitis/effusion). SRM was 1.23 for WIPE-osteitis, while lower for WIPE-synovitis/effusion and HIMRISS. CONCLUSION MRI-WIPE and HIMRISS may after further validation be useful in future spondyloarthritis trials.
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Affiliation(s)
- Marie Wetterslev
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Robert Gw Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada; Medical Imaging Consultants, Edmonton, Alberta, Canada
| | - Walter P Maksymowych
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; CARE Arthritis, Edmonton, Alberta, Canada
| | - Iris Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Israel
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Paul Bird
- Division of Medicine, University of New South Wales, Sydney, Australia
| | - Maria S Stoenoiu
- Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium
| | - Simon Krabbe
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Ashish J Mathew
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Violaine Foltz
- Department of Rheumatology, Sorbonne Universités, APHP, Pitié-Salpêtrière Hospital, Paris, France
| | - Frédérique Gandjbakhch
- Department of Rheumatology, Sorbonne Universités, APHP, Pitié-Salpêtrière Hospital, Paris, France
| | | | - Gabriele De Marco
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Helena Marzo-Ortega
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Philippe Carron
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; VIB Inflammation Research Centre, Ghent University, Ghent, Belgium
| | - Anna Ef Poulsen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Jacob L Jaremko
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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12
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Wetterslev M, Østergaard M, Sørensen IJ, Weber U, Loft AG, Kollerup G, Juul L, Thamsborg G, Madsen OR, Møller JM, Pedersen SJ. Development and Validation of 3 Preliminary MRI Sacroiliac Joint Composite Structural Damage Scores In a 5-year Longitudinal Axial Spondyloarthritis Study. J Rheumatol 2021; 48:1537-1546. [PMID: 33858979 DOI: 10.3899/jrheum.201075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE In axial spondyloarthritis (axSpA), sacroiliac joint (SIJ) erosion is often followed by fat metaplasia in an erosion cavity (backfill), and subsequently ankylosis. We aimed to combine the Spondyloarthritis Research Consortium of Canada (SPARCC) SIJ structural score for erosion, backfill, and ankylosis into 3 versions of a novel preliminary axSpA magnetic resonance imaging (MRI) SIJ Composite Structural Damage Score (CSDS) and to test these. METHODS Thirty-three patients with axSpA, followed for 5 years after initiation of tumor necrosis factor inhibitor, had MRIs of the SIJs at baseline, and yearly thereafter. Three versions of CSDS were calculated based on different weightings of erosion, backfill, and ankylosis: (1) equal weighting: CSDSequal = (erosion × 0.5) + backfill + ankylosis; (2) advanced stages weighting more: CSDSstepwise = (erosion × 1) + (backfill × 4 ) + (ankylosis × 6); and (3) advanced stages overruling earlier stages ("hierarchical") with "<" meaning "overruled by": CSDShierarchical = (erosion × 1) < (backfill × 4) < (ankylosis × 6). RESULTS At baseline, all CSDS correlated positively with SPARCC fat and ankylosis scores and modified New York radiography grading, and negatively with the Bath Ankylosing Spondylitis Disease Index and SPARCC SIJ inflammation scores. CSDSstepwise and CSDShierarchical (not CSDSequal) correlated positively with symptom duration and the Bath Ankylosing Spondylitis Metrology Index, and closer with SPARCC ankylosis score and modified New York radiography grading than CSDSequal. The adjusted annual progression rate for CSDSstepwise and CSDShierarchical (not CSDSequal) was higher the first year compared with fourth year (P = 0.04 and P = 0.01). Standardized response mean (baseline to Week 46) was moderate for CSDShierarchical (0.64) and CSDSstepwise (0.59) and small for CSDSequal (0.25). CONCLUSION Particularly CSDSstepwise and CSDShierarchical showed construct validity and responsiveness, encouraging further validation in larger clinical trials. The potential clinical implication is assessment of SIJ damage progression by 1 composite score.
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Affiliation(s)
- Marie Wetterslev
- The Biomarkers in Spondylarthritis study (BIOSPA; ClinicalTrials.gov: NCT00133315) was conducted without any financial support. The Danish Rheumatism Association supported MW with a PhD fellowship grant (R131-A5381). . Wetterslev, MD, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen, Copenhagen; I.J. Sørensen, MD, PhD, G. Kollerup, MD, PhD, L. Juul, MD, PhD, G. Thamsborg, MD, DMSc, O.R. Madsen, MD, PhD, DMSc, S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen; U. Weber, MD, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Soenderborg, and Department of Regional Health Research, University of Southern Denmark, Odense; A.G. Loft, MD, PhD, Department of Rheumatology, Lillebælt Hospital, Vejle, Department of Rheumatology, Aarhus University Hospital, Aarhus; J.M. Møller, PhD, Department of Radiology, Herlev and Gentofte Hospital, Copenhagen, Denmark. MØ has received research support, consultancy fees and/or speaker fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB. SJP has received speaker fees from MSD, Pfizer, AbbVie, Novartis, and UCB; has been an advisory board member for AbbVie and Novartis; and has received research support from AbbVie, MSD, and Novartis. AGL has been a consultant and advisor for AbbVie, Eli Lilly, MSD, Novartis, Pfizer, and UCB and has received speaker fees from AbbVie, MSD, Novartis, Pfizer, and UCB. GK has received speaker fees from Eli Lilly. MW, IJS, UW, LJ, GT, ORM, and JMM declare no conflicts of interest relevant to this article. Address correspondence to Dr. M. Wetterslev, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansens Vej 17, 2600 Glostrup, Denmark. . Accepted for publication March 31, 2021
| | - Mikkel Østergaard
- The Biomarkers in Spondylarthritis study (BIOSPA; ClinicalTrials.gov: NCT00133315) was conducted without any financial support. The Danish Rheumatism Association supported MW with a PhD fellowship grant (R131-A5381). . Wetterslev, MD, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen, Copenhagen; I.J. Sørensen, MD, PhD, G. Kollerup, MD, PhD, L. Juul, MD, PhD, G. Thamsborg, MD, DMSc, O.R. Madsen, MD, PhD, DMSc, S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen; U. Weber, MD, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Soenderborg, and Department of Regional Health Research, University of Southern Denmark, Odense; A.G. Loft, MD, PhD, Department of Rheumatology, Lillebælt Hospital, Vejle, Department of Rheumatology, Aarhus University Hospital, Aarhus; J.M. Møller, PhD, Department of Radiology, Herlev and Gentofte Hospital, Copenhagen, Denmark. MØ has received research support, consultancy fees and/or speaker fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB. SJP has received speaker fees from MSD, Pfizer, AbbVie, Novartis, and UCB; has been an advisory board member for AbbVie and Novartis; and has received research support from AbbVie, MSD, and Novartis. AGL has been a consultant and advisor for AbbVie, Eli Lilly, MSD, Novartis, Pfizer, and UCB and has received speaker fees from AbbVie, MSD, Novartis, Pfizer, and UCB. GK has received speaker fees from Eli Lilly. MW, IJS, UW, LJ, GT, ORM, and JMM declare no conflicts of interest relevant to this article. Address correspondence to Dr. M. Wetterslev, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansens Vej 17, 2600 Glostrup, Denmark. . Accepted for publication March 31, 2021
| | - Inge J Sørensen
- The Biomarkers in Spondylarthritis study (BIOSPA; ClinicalTrials.gov: NCT00133315) was conducted without any financial support. The Danish Rheumatism Association supported MW with a PhD fellowship grant (R131-A5381). . Wetterslev, MD, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen, Copenhagen; I.J. Sørensen, MD, PhD, G. Kollerup, MD, PhD, L. Juul, MD, PhD, G. Thamsborg, MD, DMSc, O.R. Madsen, MD, PhD, DMSc, S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen; U. Weber, MD, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Soenderborg, and Department of Regional Health Research, University of Southern Denmark, Odense; A.G. Loft, MD, PhD, Department of Rheumatology, Lillebælt Hospital, Vejle, Department of Rheumatology, Aarhus University Hospital, Aarhus; J.M. Møller, PhD, Department of Radiology, Herlev and Gentofte Hospital, Copenhagen, Denmark. MØ has received research support, consultancy fees and/or speaker fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB. SJP has received speaker fees from MSD, Pfizer, AbbVie, Novartis, and UCB; has been an advisory board member for AbbVie and Novartis; and has received research support from AbbVie, MSD, and Novartis. AGL has been a consultant and advisor for AbbVie, Eli Lilly, MSD, Novartis, Pfizer, and UCB and has received speaker fees from AbbVie, MSD, Novartis, Pfizer, and UCB. GK has received speaker fees from Eli Lilly. MW, IJS, UW, LJ, GT, ORM, and JMM declare no conflicts of interest relevant to this article. Address correspondence to Dr. M. Wetterslev, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansens Vej 17, 2600 Glostrup, Denmark. . Accepted for publication March 31, 2021
| | - Ulrich Weber
- The Biomarkers in Spondylarthritis study (BIOSPA; ClinicalTrials.gov: NCT00133315) was conducted without any financial support. The Danish Rheumatism Association supported MW with a PhD fellowship grant (R131-A5381). . Wetterslev, MD, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen, Copenhagen; I.J. Sørensen, MD, PhD, G. Kollerup, MD, PhD, L. Juul, MD, PhD, G. Thamsborg, MD, DMSc, O.R. Madsen, MD, PhD, DMSc, S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen; U. Weber, MD, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Soenderborg, and Department of Regional Health Research, University of Southern Denmark, Odense; A.G. Loft, MD, PhD, Department of Rheumatology, Lillebælt Hospital, Vejle, Department of Rheumatology, Aarhus University Hospital, Aarhus; J.M. Møller, PhD, Department of Radiology, Herlev and Gentofte Hospital, Copenhagen, Denmark. MØ has received research support, consultancy fees and/or speaker fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB. SJP has received speaker fees from MSD, Pfizer, AbbVie, Novartis, and UCB; has been an advisory board member for AbbVie and Novartis; and has received research support from AbbVie, MSD, and Novartis. AGL has been a consultant and advisor for AbbVie, Eli Lilly, MSD, Novartis, Pfizer, and UCB and has received speaker fees from AbbVie, MSD, Novartis, Pfizer, and UCB. GK has received speaker fees from Eli Lilly. MW, IJS, UW, LJ, GT, ORM, and JMM declare no conflicts of interest relevant to this article. Address correspondence to Dr. M. Wetterslev, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansens Vej 17, 2600 Glostrup, Denmark. . Accepted for publication March 31, 2021
| | - Anne G Loft
- The Biomarkers in Spondylarthritis study (BIOSPA; ClinicalTrials.gov: NCT00133315) was conducted without any financial support. The Danish Rheumatism Association supported MW with a PhD fellowship grant (R131-A5381). . Wetterslev, MD, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen, Copenhagen; I.J. Sørensen, MD, PhD, G. Kollerup, MD, PhD, L. Juul, MD, PhD, G. Thamsborg, MD, DMSc, O.R. Madsen, MD, PhD, DMSc, S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen; U. Weber, MD, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Soenderborg, and Department of Regional Health Research, University of Southern Denmark, Odense; A.G. Loft, MD, PhD, Department of Rheumatology, Lillebælt Hospital, Vejle, Department of Rheumatology, Aarhus University Hospital, Aarhus; J.M. Møller, PhD, Department of Radiology, Herlev and Gentofte Hospital, Copenhagen, Denmark. MØ has received research support, consultancy fees and/or speaker fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB. SJP has received speaker fees from MSD, Pfizer, AbbVie, Novartis, and UCB; has been an advisory board member for AbbVie and Novartis; and has received research support from AbbVie, MSD, and Novartis. AGL has been a consultant and advisor for AbbVie, Eli Lilly, MSD, Novartis, Pfizer, and UCB and has received speaker fees from AbbVie, MSD, Novartis, Pfizer, and UCB. GK has received speaker fees from Eli Lilly. MW, IJS, UW, LJ, GT, ORM, and JMM declare no conflicts of interest relevant to this article. Address correspondence to Dr. M. Wetterslev, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansens Vej 17, 2600 Glostrup, Denmark. . Accepted for publication March 31, 2021
| | - Gina Kollerup
- The Biomarkers in Spondylarthritis study (BIOSPA; ClinicalTrials.gov: NCT00133315) was conducted without any financial support. The Danish Rheumatism Association supported MW with a PhD fellowship grant (R131-A5381). . Wetterslev, MD, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen, Copenhagen; I.J. Sørensen, MD, PhD, G. Kollerup, MD, PhD, L. Juul, MD, PhD, G. Thamsborg, MD, DMSc, O.R. Madsen, MD, PhD, DMSc, S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen; U. Weber, MD, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Soenderborg, and Department of Regional Health Research, University of Southern Denmark, Odense; A.G. Loft, MD, PhD, Department of Rheumatology, Lillebælt Hospital, Vejle, Department of Rheumatology, Aarhus University Hospital, Aarhus; J.M. Møller, PhD, Department of Radiology, Herlev and Gentofte Hospital, Copenhagen, Denmark. MØ has received research support, consultancy fees and/or speaker fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB. SJP has received speaker fees from MSD, Pfizer, AbbVie, Novartis, and UCB; has been an advisory board member for AbbVie and Novartis; and has received research support from AbbVie, MSD, and Novartis. AGL has been a consultant and advisor for AbbVie, Eli Lilly, MSD, Novartis, Pfizer, and UCB and has received speaker fees from AbbVie, MSD, Novartis, Pfizer, and UCB. GK has received speaker fees from Eli Lilly. MW, IJS, UW, LJ, GT, ORM, and JMM declare no conflicts of interest relevant to this article. Address correspondence to Dr. M. Wetterslev, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansens Vej 17, 2600 Glostrup, Denmark. . Accepted for publication March 31, 2021
| | - Lars Juul
- The Biomarkers in Spondylarthritis study (BIOSPA; ClinicalTrials.gov: NCT00133315) was conducted without any financial support. The Danish Rheumatism Association supported MW with a PhD fellowship grant (R131-A5381). . Wetterslev, MD, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen, Copenhagen; I.J. Sørensen, MD, PhD, G. Kollerup, MD, PhD, L. Juul, MD, PhD, G. Thamsborg, MD, DMSc, O.R. Madsen, MD, PhD, DMSc, S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen; U. Weber, MD, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Soenderborg, and Department of Regional Health Research, University of Southern Denmark, Odense; A.G. Loft, MD, PhD, Department of Rheumatology, Lillebælt Hospital, Vejle, Department of Rheumatology, Aarhus University Hospital, Aarhus; J.M. Møller, PhD, Department of Radiology, Herlev and Gentofte Hospital, Copenhagen, Denmark. MØ has received research support, consultancy fees and/or speaker fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB. SJP has received speaker fees from MSD, Pfizer, AbbVie, Novartis, and UCB; has been an advisory board member for AbbVie and Novartis; and has received research support from AbbVie, MSD, and Novartis. AGL has been a consultant and advisor for AbbVie, Eli Lilly, MSD, Novartis, Pfizer, and UCB and has received speaker fees from AbbVie, MSD, Novartis, Pfizer, and UCB. GK has received speaker fees from Eli Lilly. MW, IJS, UW, LJ, GT, ORM, and JMM declare no conflicts of interest relevant to this article. Address correspondence to Dr. M. Wetterslev, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansens Vej 17, 2600 Glostrup, Denmark. . Accepted for publication March 31, 2021
| | - Gorm Thamsborg
- The Biomarkers in Spondylarthritis study (BIOSPA; ClinicalTrials.gov: NCT00133315) was conducted without any financial support. The Danish Rheumatism Association supported MW with a PhD fellowship grant (R131-A5381). . Wetterslev, MD, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen, Copenhagen; I.J. Sørensen, MD, PhD, G. Kollerup, MD, PhD, L. Juul, MD, PhD, G. Thamsborg, MD, DMSc, O.R. Madsen, MD, PhD, DMSc, S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen; U. Weber, MD, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Soenderborg, and Department of Regional Health Research, University of Southern Denmark, Odense; A.G. Loft, MD, PhD, Department of Rheumatology, Lillebælt Hospital, Vejle, Department of Rheumatology, Aarhus University Hospital, Aarhus; J.M. Møller, PhD, Department of Radiology, Herlev and Gentofte Hospital, Copenhagen, Denmark. MØ has received research support, consultancy fees and/or speaker fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB. SJP has received speaker fees from MSD, Pfizer, AbbVie, Novartis, and UCB; has been an advisory board member for AbbVie and Novartis; and has received research support from AbbVie, MSD, and Novartis. AGL has been a consultant and advisor for AbbVie, Eli Lilly, MSD, Novartis, Pfizer, and UCB and has received speaker fees from AbbVie, MSD, Novartis, Pfizer, and UCB. GK has received speaker fees from Eli Lilly. MW, IJS, UW, LJ, GT, ORM, and JMM declare no conflicts of interest relevant to this article. Address correspondence to Dr. M. Wetterslev, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansens Vej 17, 2600 Glostrup, Denmark. . Accepted for publication March 31, 2021
| | - Ole R Madsen
- The Biomarkers in Spondylarthritis study (BIOSPA; ClinicalTrials.gov: NCT00133315) was conducted without any financial support. The Danish Rheumatism Association supported MW with a PhD fellowship grant (R131-A5381). . Wetterslev, MD, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen, Copenhagen; I.J. Sørensen, MD, PhD, G. Kollerup, MD, PhD, L. Juul, MD, PhD, G. Thamsborg, MD, DMSc, O.R. Madsen, MD, PhD, DMSc, S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen; U. Weber, MD, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Soenderborg, and Department of Regional Health Research, University of Southern Denmark, Odense; A.G. Loft, MD, PhD, Department of Rheumatology, Lillebælt Hospital, Vejle, Department of Rheumatology, Aarhus University Hospital, Aarhus; J.M. Møller, PhD, Department of Radiology, Herlev and Gentofte Hospital, Copenhagen, Denmark. MØ has received research support, consultancy fees and/or speaker fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB. SJP has received speaker fees from MSD, Pfizer, AbbVie, Novartis, and UCB; has been an advisory board member for AbbVie and Novartis; and has received research support from AbbVie, MSD, and Novartis. AGL has been a consultant and advisor for AbbVie, Eli Lilly, MSD, Novartis, Pfizer, and UCB and has received speaker fees from AbbVie, MSD, Novartis, Pfizer, and UCB. GK has received speaker fees from Eli Lilly. MW, IJS, UW, LJ, GT, ORM, and JMM declare no conflicts of interest relevant to this article. Address correspondence to Dr. M. Wetterslev, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansens Vej 17, 2600 Glostrup, Denmark. . Accepted for publication March 31, 2021
| | - Jakob M Møller
- The Biomarkers in Spondylarthritis study (BIOSPA; ClinicalTrials.gov: NCT00133315) was conducted without any financial support. The Danish Rheumatism Association supported MW with a PhD fellowship grant (R131-A5381). . Wetterslev, MD, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen, Copenhagen; I.J. Sørensen, MD, PhD, G. Kollerup, MD, PhD, L. Juul, MD, PhD, G. Thamsborg, MD, DMSc, O.R. Madsen, MD, PhD, DMSc, S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen; U. Weber, MD, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Soenderborg, and Department of Regional Health Research, University of Southern Denmark, Odense; A.G. Loft, MD, PhD, Department of Rheumatology, Lillebælt Hospital, Vejle, Department of Rheumatology, Aarhus University Hospital, Aarhus; J.M. Møller, PhD, Department of Radiology, Herlev and Gentofte Hospital, Copenhagen, Denmark. MØ has received research support, consultancy fees and/or speaker fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB. SJP has received speaker fees from MSD, Pfizer, AbbVie, Novartis, and UCB; has been an advisory board member for AbbVie and Novartis; and has received research support from AbbVie, MSD, and Novartis. AGL has been a consultant and advisor for AbbVie, Eli Lilly, MSD, Novartis, Pfizer, and UCB and has received speaker fees from AbbVie, MSD, Novartis, Pfizer, and UCB. GK has received speaker fees from Eli Lilly. MW, IJS, UW, LJ, GT, ORM, and JMM declare no conflicts of interest relevant to this article. Address correspondence to Dr. M. Wetterslev, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansens Vej 17, 2600 Glostrup, Denmark. . Accepted for publication March 31, 2021
| | - Susanne J Pedersen
- The Biomarkers in Spondylarthritis study (BIOSPA; ClinicalTrials.gov: NCT00133315) was conducted without any financial support. The Danish Rheumatism Association supported MW with a PhD fellowship grant (R131-A5381). . Wetterslev, MD, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen, Copenhagen; I.J. Sørensen, MD, PhD, G. Kollerup, MD, PhD, L. Juul, MD, PhD, G. Thamsborg, MD, DMSc, O.R. Madsen, MD, PhD, DMSc, S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen; U. Weber, MD, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Soenderborg, and Department of Regional Health Research, University of Southern Denmark, Odense; A.G. Loft, MD, PhD, Department of Rheumatology, Lillebælt Hospital, Vejle, Department of Rheumatology, Aarhus University Hospital, Aarhus; J.M. Møller, PhD, Department of Radiology, Herlev and Gentofte Hospital, Copenhagen, Denmark. MØ has received research support, consultancy fees and/or speaker fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB. SJP has received speaker fees from MSD, Pfizer, AbbVie, Novartis, and UCB; has been an advisory board member for AbbVie and Novartis; and has received research support from AbbVie, MSD, and Novartis. AGL has been a consultant and advisor for AbbVie, Eli Lilly, MSD, Novartis, Pfizer, and UCB and has received speaker fees from AbbVie, MSD, Novartis, Pfizer, and UCB. GK has received speaker fees from Eli Lilly. MW, IJS, UW, LJ, GT, ORM, and JMM declare no conflicts of interest relevant to this article. Address correspondence to Dr. M. Wetterslev, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansens Vej 17, 2600 Glostrup, Denmark. . Accepted for publication March 31, 2021
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Malik F, Scherl E, Weber U, Carrino JA, Epsten M, Wichuk S, Pedersen SJ, Paschke J, Schwartzman S, Kroeber G, Maksymowych WP, Longman R, Mandl LA. Utility of magnetic resonance imaging in Crohn's associated sacroiliitis: A cross-sectional study. Int J Rheum Dis 2021; 24:582-590. [PMID: 33528900 DOI: 10.1111/1756-185x.14081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 12/14/2020] [Accepted: 01/09/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Prevalence of sacroiliitis in Crohn's disease (CD) is variable depending on defining criteria. This study utilized standardized sacroiliac joint (SIJ) magnetic resonance imaging (MRI) to identify sacroiliitis in CD patients and its association with clinical and serological markers. METHODS Consecutive adult subjects with CD prospectively enrolled from an inflammatory bowel disease clinic underwent SIJ MRI. Data collected included CD duration, history of joint/back pain, human leukocyte antigen-B27 status, Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Disease Activity Index, Harvey Bradshaw Index (HBI) for activity of CD, Ankylosing Spondylitis Disease Activity Score, and various serologic markers of inflammation. Three blinded readers reviewed MRIs for active and structural lesions according to the Spondyloarthritis Research Consortium of Canada modules. RESULTS Thirty-three CD patients were enrolled: 76% female, 80% White, median age 36.4 years (interquartile range 27.2-49.0), moderate CD activity (mean HBI 8.8 ± SD 4.5). Nineteen subjects (58%) reported any back pain, 13 of whom had inflammatory back pain. Four subjects (12%) showed sacroiliitis using global approach and 6 (18%) met Assessment of SpondyloArthritis international Society MRI criteria of sacroiliitis. Older age (mean 51.2 ± SD 12.5 vs. 37.2 ± 14; P = .04), history of dactylitis (50.0% vs. 3.4%, P = .03) and worse BASMI (4.1 ± 0.7 vs. 2.4 ± 0.8, P ≤ .001) were associated with MRI sacroiliitis; no serologic measure was associated. CONCLUSION There were 12%-18% of CD patients who had MRI evidence of sacroiliitis, which was not associated with back pain, CD activity or serologic measures. This data suggests that MRI is a useful modality to identify subclinical sacroiliitis in CD patients.
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Affiliation(s)
- Fardina Malik
- Division of Rheumatology, Department of Medicine, NYU School of Medicine, New York, NY, USA
| | - Ellen Scherl
- Weill Cornell Medicine, Jill Roberts Institute for Research in Inflammatory Bowel Disease, New York, NY, USA
| | - Ulrich Weber
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - John A Carrino
- Department of Radiology and Imaging, Hospital for Special Surgery and Weill Cornell Medicine, New York, NY, USA
| | | | | | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Georg Kroeber
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark
| | - Walter P Maksymowych
- University of Alberta, Edmonton, AB, Canada.,CARE Arthritis, Edmonton, AB, Canada
| | - Randy Longman
- Weill Cornell Medicine, Jill Roberts Institute for Research in Inflammatory Bowel Disease, New York, NY, USA
| | - Lisa A Mandl
- Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine, New York, NY, USA
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14
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Maksymowych WP, Lambert RG, Baraliakos X, Weber U, Machado P, Pedersen SJ, Hooge MD, Sieper J, Wichuk S, Poddubnyy D, Rudwaleit M, van der Heijde D, Landewe R, Eshed I, Ostergaard M. Data-driven definitions for active and structural MRI lesions in the sacroiliac joint in spondyloarthritis and their predictive utility. Rheumatology (Oxford) 2021; 60:4778-4789. [DOI: 10.1093/rheumatology/keab099] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/15/2021] [Indexed: 12/17/2022] Open
Abstract
Abstract
Objectives
To determine quantitative SI joint MRI lesion cut-offs that optimally define a positive MRI for inflammatory and structural lesions typical of axial SpA (axSpA) and that predict clinical diagnosis.
Methods
The Assessment of SpondyloArthritis international Society (ASAS) MRI group assessed MRIs from the ASAS Classification Cohort in two reading exercises where (A) 169 cases and 7 central readers; (B) 107 cases and 8 central readers. We calculated sensitivity/specificity for the number of SI joint quadrants or slices with bone marrow oedema (BME), erosion, fat lesion, where a majority of central readers had high confidence there was a definite active or structural lesion. Cut-offs with ≥95% specificity were analysed for their predictive utility for follow-up rheumatologist diagnosis of axSpA by calculating positive/negative predictive values (PPVs/NPVs) and selecting cut-offs with PPV ≥ 95%.
Results
Active or structural lesions typical of axSpA on MRI had PPVs ≥ 95% for clinical diagnosis of axSpA. Cut-offs that best reflected a definite active lesion typical of axSpA were either ≥4 SI joint quadrants with BME at any location or at the same location in ≥3 consecutive slices. For definite structural lesion, the optimal cut-offs were any one of ≥3 SI joint quadrants with erosion or ≥5 with fat lesions, erosion at the same location for ≥2 consecutive slices, fat lesions at the same location for ≥3 consecutive slices, or presence of a deep (i.e. >1 cm depth) fat lesion.
Conclusion
We propose cut-offs for definite active and structural lesions typical of axSpA that have high PPVs for a long-term clinical diagnosis of axSpA for application in disease classification and clinical research.
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Affiliation(s)
| | - Robert G Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada
- Medical Imaging Consultants, Edmonton, Canada
| | | | - Ulrich Weber
- Department of Rheumatology, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Pedro M Machado
- Department of Rheumatology, University College London Hospitals NHS Foundation Trust
- Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust
- Centre for Rheumatology and MRC Centre for Neuromuscular Diseases, University College London, London, UK
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Copenhagen, Denmark
| | - Manouk de Hooge
- VIB Inflammation Research Center, Ghent University
- Rheumatology Department, Ghent University Hospital, Ghent, Belgium
| | - Joachim Sieper
- Department of Rheumatology, Charité – Universitätsmedizin Berlin and German Rheumatism Research Centre, Berlin
| | | | - Denis Poddubnyy
- Department of Rheumatology, Charité – Universitätsmedizin Berlin and German Rheumatism Research Centre, Berlin
| | - Martin Rudwaleit
- Klinikum Bielefeld, Bielefeld
- Department of Rheumatology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | | | - Robert Landewe
- Department of Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam
- Atrium Medical Center, Heerlen, the Netherlands
| | - Iris Eshed
- Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Mikkel Ostergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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15
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Møller JM, Østergaard M, Thomsen HS, Hangaard S, Sørensen IJ, Madsen OR, Pedersen SJ. Repeatability and reproducibility of MRI apparent diffusion coefficient applied on four different regions of interest for patients with axial spondyloarthritis and healthy volunteers scanned twice within a week. BJR Open 2021; 2:20200004. [PMID: 33409446 PMCID: PMC7768406 DOI: 10.1259/bjro.20200004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 09/24/2020] [Accepted: 10/28/2020] [Indexed: 11/05/2022] Open
Abstract
Objectives: The apparent diffusion coefficient (ADC) may be used as a biomarker for diagnosis and/or monitoring treatment response in patients with axial spondyloarthritis (axSpA), but this requires reliable ADC measurements. This study assessed test–retest repeatability and reproducibility of ADC measurements using four different region of interest (ROI) settings. Methods: In this prospective study, the sacroiliac joints (SIJs) of 25 patients with axSpA and 24 age- and sex-matched healthy volunteers were imaged twice at a mean interval of 6.8 days in a 1.5 T scanner using, multishot echoplanar diffusion-weighted sequences. ADCs at four ROI settings were assessed: 5 mm and 10 mm anatomic band-shaped, 15 mm linear, and 40 mm2 circular. Results: Intraclass correlation coefficient (ICC) assessments showed that the interstudy repeatability was good for median ADC (ADCmed) and 95th-percentile ADC (ADC95) measurements in patients with axSpA (0.77–0.83 and 0.75–0.83, respectively), but poor-to-moderate in healthy subjects (0.27–0.55 and 0.13–0.37, respectively). For all ROI settings, intrareader reproducibility was excellent for ADCmed-measurements (ICC:0.85–0.99) and moderate-to-excellent for ADC95 measurements (ICC:0.68–0.96). The 5 mm ROI had the least estimated bias and highest level of agreement on Bland–Altman plots. The interreader reproducibility was moderate (ICC:0.71). The 15 mm linear ROI produced significantly greater ADCmed and ADC95 measurements than all other ROI settings (p < 0.01–0.02), except for the circular ROI ADC95 measurements. Conclusion: ROI settings influence ADC measurements. Interstudy repeatability of SIJ ADC measurements is independent of ROI settings. However, the 5 mm ROI showed the least bias and random error and seems preferable. Advances in knowledge: ADC measurements are affected by ROI settings, and this should be taken into account when assessing ADC maps.
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Affiliation(s)
| | | | | | - Stine Hangaard
- Department of Radiology, Herlev-Gentofte Hospital, Herlev, Denmark
| | | | | | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
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16
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Møller JM, Østergaard M, Thomsen HS, Krabbe S, Sørensen IJ, Jensen B, Madsen OR, Klarlund M, Pedersen SJ. Validation of assessment methods for the apparent diffusion coefficient in a clinical trial of axial spondyloarthritis patients treated with golimumab. Eur J Radiol Open 2020; 7:100285. [PMID: 33204770 PMCID: PMC7649611 DOI: 10.1016/j.ejro.2020.100285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/25/2020] [Indexed: 01/06/2023] Open
Abstract
Purpose To compare three region-of-interest (ROI) settings in the assessment of ADC in a clinical trial, and to evaluate the effectiveness of ADC in assessing therapy-induced changes and predicting clinical outcomes. Methods In a 52-week clinical trial involving patients with axial spondyloarthritis, mean sacroiliac joint (SIJ) ADC measurements using structured, lesion-based, and index-lesion ROI-settings were assessed at baseline and weeks 4, 16, and 52. Variation among the three ROI-settings, correlations with Spondyloarthritis Research Consortium of Canada (SPARCC)-bone marrow edema (BME) SIJ inflammation indices, standardized response means (SRMs), and effectiveness in predicting clinical outcomes were analyzed. Results Forty of the 53 patients had at least one assessable SIJ lesion on ADC at baseline. The mean of the structured ROI ADC (ADCstruc) was 230 μmm2/s (standard deviation [SD] = 120). This was significantly lower (p < 0.01) than the means of the lesion-based ROI ADC (ADClesion = 420 μmm2/s, SD = 210) and index-lesion ROI ADC (ADCindex = 471 μmm2/s, SD = 278), which did not differ. ADC correlated with SPARCC-BME scores at baseline (p < 0.01) as did changes over time in ADC- and SPARCC-BME (p<0.05). At all follow-up time points, responsiveness was high for ADClesion (SRM > 0.92) and ADCindex (SRM > 0.87) while moderate for ADCstruc (SRM:0.54-0.67). Baseline ADC and changes in ADC did not predict clinical outcomes. Conclusions Lesion-based and index-lesion ROI ADC could both be used to evaluate the effectiveness of tumor necrosis factor inhibitor therapy. None of the methods could predict clinical outcomes.
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Affiliation(s)
- Jakob M Møller
- Department of Radiology, Herlev and Gentofte Hospital, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Østergaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - Henrik S Thomsen
- Department of Radiology, Herlev and Gentofte Hospital, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Simon Krabbe
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - Inge J Sørensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - Bente Jensen
- Center for Rheumatology and Spine Diseases, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Ole Rintek Madsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Center for Rheumatology and Spine Diseases, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Mette Klarlund
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - Susanne J Pedersen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Center for Rheumatology and Spine Diseases, Herlev and Gentofte Hospital, Hellerup, Denmark
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17
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Krabbe S, Eshed I, Sørensen IJ, Møller J, Jensen B, Madsen OR, Klarlund M, Pedersen SJ, Østergaard M. Novel whole-body magnetic resonance imaging response and remission criteria document diminished inflammation during golimumab treatment in axial spondyloarthritis. Rheumatology (Oxford) 2020; 59:3358-3368. [PMID: 32310294 DOI: 10.1093/rheumatology/keaa153] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 02/24/2020] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To investigate criteria for treatment response and remission in patients with axial SpA as assessed by whole-body magnetic resonance imaging (WB-MRI) of axial and peripheral joints and entheses during treatment with golimumab. METHODS We performed an investigator-initiated cohort study of 53 patients who underwent WB-MRI at weeks 0, 4, 16 and 52 after initiation of golimumab. Images were assessed according to the Spondyloarthritis Research Consortium of Canada MRI SI joint inflammation index, Canada-Denmark MRI spine inflammation score and the MRI peripheral joints and entheses inflammation index. RESULTS At weeks 4, 16 and 52, WB-MRI demonstrated an at least 50% reduction of MRI inflammation of the sacroiliac joints in 16, 29 and 32 (30%, 55% and 60%) patients, of the spine in 20, 30 and 31 (38%, 57% and 58%) patients and of peripheral joints and entheses in 8, 17 and 15 (15%, 32% and 28%) patients, respectively. The BASDAI50 response was achieved by 29, 31 and 31 (55%, 58% and 58%) patients, while ASDAS clinically important improvement (ASDAS-CII) was achieved by 37, 40 and 34 (70%, 75% and 64%) patients. WB-MRI remission criteria for spine, sacroiliac joints and peripheral joints and entheses were explored; total WB-MRI remission was attained by 2, 6 and 3 (4%, 11% and 6%) patients. At week 16, among 35 patients with an at least 50% reduction in the MRI Axial Inflammation Index (sacroiliac joint and spine inflammation), 29 (83%) achieved BASDAI50 and 35 (100%) achieved ASDAS-CII; among 16 patients with MRI axial inflammation non-response, 14 (88%) were BASDAI50 non-responders and 11 (69%) did not achieve ASDAS-CII. CONCLUSION WB-MRI demonstrated a significant reduction of inflammation in both the spine, sacroiliac joints and peripheral joints and entheses during golimumab treatment. Few patients achieved total WB-MRI remission. Combining spinal and sacroiliac joint inflammation in an MRI Axial Inflammation Index increased the ability to capture response. TRIAL REGISTRATION ClinicalTrials.gov, http://clinicaltrials.gov, NCT02011386.
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Affiliation(s)
- Simon Krabbe
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Iris Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Inge J Sørensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Møller
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Radiology, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Bente Jensen
- Center for Rheumatology and Spine Diseases, Frederiksberg Hospital, Frederiksberg, Denmark
| | - Ole R Madsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Center for Rheumatology and Spine Diseases, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Mette Klarlund
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Center for Rheumatology and Spine Diseases, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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18
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Krabbe S, Østergaard M, Sørensen IJ, Møller J, Jensen B, Madsen OR, Pedersen SJ. High versus standard magnetic resonance image resolution of the cervical spine in patients with axial spondyloarthritis. Acta Radiol 2020; 61:471-479. [PMID: 31480852 DOI: 10.1177/0284185119872689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Sagittal magnetic resonance (MR) images are typically obtained with the same spatial resolution along the entire spine, but cervical vertebrae are smaller and may be harder to assess. Purpose To investigate if high-resolution (high-res) short tau inversion recovery (STIR) and T1-weighted turbo spin echo (T1W) MR imaging (MRI) sequences are superior to standard resolution for detecting inflammatory and structural lesions in the cervical spine of patients with axial spondyloarthritis. Material and Methods Images were obtained in 36 patients. Voxel sizes at high/standard resolution were 1.99/4.33 mm3 (STIR) and 0.89/3.71 mm3 (T1W). High-resolution and standard-resolution images were scored by two readers according to the Canada-Denmark (CANDEN) MRI spine scoring system. Results Higher bone marrow edema scores were obtained at high resolution versus standard resolution (mean 2.1 vs. 1.2, P = 0.040), whereas fat lesion scores (1.8 vs. 1.5, P = 0.27) and new bone formation scores (3.5 vs. 2.8, P = 0.21) were similar. High-resolution MRI did not classify more patients as positive for bone marrow edema, fat, or new bone formation in the cervical spine compared to standard resolution. Using lateral radiographs as reference standard, sensitivity for detecting anterior corner syndesmophytes with both high-resolution and standard-resolution MRI was low (range 7–22%) and sensitivity for detecting ankylosis was low to moderate (20–55%), while specificity was high (≥96%). Conclusion High-resolution MRI allowed identification of more inflammatory lesions in the cervical spine in patients with axial spondyloarthritis when compared to standard resolution, but it did not classify more patients as positive for bone marrow edema. The slightly increased sensitivity at high-resolution MRI seemed to be too modest to have any real clinical importance.
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Affiliation(s)
- Simon Krabbe
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Inge J Sørensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Møller
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Radiology, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Bente Jensen
- Center for Rheumatology and Spine Diseases, Frederiksberg Hospital, Denmark
| | - Ole R Madsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Rheumatology and Spine Diseases, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Møller JM, Østergaard M, Thomsen HS, Sørensen IJ, Madsen OR, Pedersen SJ. Test-retest repeatability of the apparent diffusion coefficient in sacroiliac joint MRI in patients with axial spondyloarthritis and healthy individuals. Acta Radiol Open 2020; 9:2058460120906015. [PMID: 32206343 PMCID: PMC7074525 DOI: 10.1177/2058460120906015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 01/21/2020] [Indexed: 01/01/2023] Open
Abstract
Background The apparent diffusion coefficient (ADC) may be used as a biomarker to diagnose axial spondyloarthritis (axSpA) and monitor therapeutic response. Purpose To measure the repeatability of the ADC in healthy individuals and in patients with axSpA with and without active sacroiliitis in a test–retest set-up, and to correlate ADC to conventional magnetic resonance imaging (MRI) bone marrow edema (BME) scores and clinical findings. Material and Methods A total of 25 patients with axSpA and 24 sex- and age-matched healthy individuals were prospectively examined with MRI twice within 10 days. Short tau inversion recovery (STIR), T1-weighted and diffusion-weighted imaging sequences were performed. Mono-exponential ADC maps were based on four b-values: 0; 50; 500; and 800. Inter-study repeatability and intra-reader reproducibility were investigated in subgroups, as were associations with conventional MRI and clinical findings. Results The inter-study repeatability for the median ADC was moderate for all individuals (intraclass correlation coefficient [ICC] 0.66); it was good in patients with axSpA (ICC 0.79) and poor in healthy individuals (ICC 0.27). Significant differences in ADC were found between women and men (P = 0.03), and between patients with versus without BME on STIR (P = 0.01). ADC was associated with an MRI BME score and with age in women. Conclusion ADC seems to be a repeatable parameter in patients with axSpA but not in healthy individuals. ADC is correlated with MRI sacroiliac joint BME score and with age in women.
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Affiliation(s)
- Jakob M Møller
- Department of Radiology, Herlev-Gentofte Hospital, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Østergaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - Henrik S Thomsen
- Department of Radiology, Herlev-Gentofte Hospital, Herlev, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Inge J Sørensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - Ole R Madsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Gentofte, Denmark
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
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20
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Mathew AJ, Krabbe S, Eshed I, Lambert RG, Laredo JD, Maksymowych WP, Gandjbakhch F, Emad Y, Stoenoiu MS, Foltz V, Bird P, Carron P, Paschke J, Conaghan PG, Pedersen SJ, Glinatsi D, Østergaard M. Atlas of the OMERACT Heel Enthesitis MRI Scoring System (HEMRIS). RMD Open 2020; 6:rmdopen-2019-001150. [PMID: 32568094 PMCID: PMC7046972 DOI: 10.1136/rmdopen-2019-001150] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/30/2019] [Accepted: 01/05/2020] [Indexed: 01/28/2023] Open
Abstract
Objective Assessment of enthesitis, a key feature in spondyloarthritis (SpA) and psoriatic arthritis (PsA), using objective and sensitive methods is pivotal in clinical trials. MRI allows detection of both soft tissue and intra-osseous changes of enthesitis. This article presents an atlas for the Outcome Measures in Rheumatology (OMERACT) Heel Enthesitis Magnetic Resonance ImagingMRI Scoring System (HEMRIS). Methods Following a preliminary selection of potential examples of each grade, as per HEMRIS definitions, the images along with detailed definitions and reader rules were discussed at web-based, interactive meetings between the members of the OMERACT MRI in Arthritis Working Group. Results Reference images of each grade of the MRI features to be assessed using HEMRIS, along with reader rules and recommended MRI sequences are depicted. Conclusion The presented reference images can be used to guide scoring Achilles tendon and plantar fascia (plantar aponeurosis) enthesitis according to the OMERACT HEMRIS in clinical trials and cohorts in which MRI enthesitis is used as an outcome.
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Affiliation(s)
- Ashish J Mathew
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Glostrup, Denmark .,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - Simon Krabbe
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Iris Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Robert Gw Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.,Medical Imaging Consultants, Edmonton, Alberta, Canada
| | - Jean-Denis Laredo
- Service de Radiologie, Hôpital Lariboisiére, APHP & Université Paris-Diderot, Paris, France
| | - Walter P Maksymowych
- CaRE (Canadian Research Education) Arthritis, Edmonton, Alberta, Canada.,Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Frederique Gandjbakhch
- Department of Rheumatology, CHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.,Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Yasser Emad
- Rheumatology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Maria Simona Stoenoiu
- Rheumatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.,Institut de Recherche Experimentale et Clinique, Universite Catholique de Louvain La Faculte de Medecine, Brussels, Belgium
| | - Violaine Foltz
- Department of Rheumatology, CHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.,Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Paul Bird
- Division of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Joel Paschke
- CaRE (Canadian Research Education) Arthritis, Edmonton, Alberta, Canada
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,Leeds Teaching Hospitals NHS Trust, NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Glostrup, Denmark
| | - Daniel Glinatsi
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Glostrup, Denmark.,Rheumatology, Skaraborg Hospital Skövde, Skovde, Sweden
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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21
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Krabbe S, Kröber G, Pedersen SJ, Østergaard M, Møller JM, Sørensen IJ, Jensen B, Madsen OR, Klarlund M, Weber U. Scoring magnetic resonance imaging (MRI) inflammation and structural lesions in sacroiliac joints of patients with axial spondyloarthritis: assessment of all MRI slices of the cartilaginous compartment versus standardized six or five slices. Scand J Rheumatol 2019; 49:200-209. [PMID: 31847676 DOI: 10.1080/03009742.2019.1675184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives: The Spondyloarthritis Research Consortium of Canada (SPARCC) sacroiliac joint (SIJ) scoring system assesses six or five (6/5) semicoronal magnetic resonance imaging (MRI) slices for inflammation/structural lesions in patients with axial spondyloarthritis (axSpA). However, the cartilaginous SIJ compartment may be visible in a few additional slices. The objective was to investigate interreader reliability, sensitivity to change, and classification of MRI scans as positive or negative for various lesion types using an 'all slices' approach versus standard SPARCC scoring of 6/5 slices.Method: Fifty-three axSpA patients were treated with the tumour necrosis factor inhibitor golimumab and followed with serial MRI scans at weeks 0, 4, 16, and 52. The most anterior and posterior slices covering the cartilaginous compartment and the transitional slice were identified. Scores for inflammation, fat metaplasia, erosion, backfill, and ankylosis in the cartilaginous SIJ compartment were calculated for the 'all slices' approach and the 6/5 slices standard.Results: By the 'all slices' approach, three readers scored mean 7.2, 7.7, and 7.0 slices per MRI scan. Baseline and change scores for the various lesion types closely correlated between the two approaches (Pearson's rho ≥ 0.95). Inflammation score was median 13 (interquartile range 6-21, range 0-49) for 6/5 slices versus 14 (interquartile range 6-23, range 0-69) for all slices at baseline. Interreader reliability, sensitivity to change, and classification of MRI scans as positive or negative for various lesion types were similar.Conclusion: The standardized 6/5 slices approach showed no relevant differences from the 'all slices' approach and, therefore, is equally suited for monitoring purposes.
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Affiliation(s)
- S Krabbe
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Frederiksberg Hospital, Gentofte Hospital, North Zealand Hospital Hillerød, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - G Kröber
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark
| | - S J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Frederiksberg Hospital, Gentofte Hospital, North Zealand Hospital Hillerød, Denmark
| | - M Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Frederiksberg Hospital, Gentofte Hospital, North Zealand Hospital Hillerød, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J M Møller
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Radiology, Herlev Hospital, Herlev, Denmark
| | - I J Sørensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Frederiksberg Hospital, Gentofte Hospital, North Zealand Hospital Hillerød, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - B Jensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Frederiksberg Hospital, Gentofte Hospital, North Zealand Hospital Hillerød, Denmark
| | - O R Madsen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Frederiksberg Hospital, Gentofte Hospital, North Zealand Hospital Hillerød, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M Klarlund
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Frederiksberg Hospital, Gentofte Hospital, North Zealand Hospital Hillerød, Denmark
| | - U Weber
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark.,Hospital of Southern Jutland, University Hospital of Southern Denmark, Aabenraa, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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22
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Arnbak B, Jensen TS, Schiøttz‐Christensen B, Pedersen SJ, Østergaard M, Weber U, Hendricks O, Zejden A, Manniche C, Jurik AG. What Level of Inflammation Leads to Structural Damage in the Sacroiliac Joints? A Four‐Year Magnetic Resonance Imaging Follow‐Up Study of Low Back Pain Patients. Arthritis Rheumatol 2019; 71:2027-2033. [DOI: 10.1002/art.41040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 07/09/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Bodil Arnbak
- University of Southern Denmark, Odense, Denmark, and Vejle HospitalHospital Lillebælt Vejle Denmark
| | - Tue S. Jensen
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark, and Silkeborg Regional Hospital Silkeborg Denmark
| | | | - Susanne J. Pedersen
- Rigshospitalet Glostrup, Glostrup, Denmark, and University of Copenhagen Copenhagen Denmark
| | - Mikkel Østergaard
- Rigshospitalet Glostrup, Glostrup, Denmark, and University of Copenhagen Copenhagen Denmark
| | - Ulrich Weber
- University of Southern Denmark, Odense, Denmark, and King Christian 10th Hospital for Rheumatic Diseases and Hospital of Southern Jutland Gråsten Denmark
| | - Oliver Hendricks
- University of Southern Denmark, Odense, Denmark, and King Christian 10th Hospital for Rheumatic Diseases and Hospital of Southern Jutland Gråsten Denmark
| | | | - Claus Manniche
- Hospital Lillebaelt, Middelfart, Denmark, and University of Southern Denmark Odense Denmark
| | - Anne G. Jurik
- Hospital Lillebaelt, Middelfart, Denmark, University of Southern Denmark, Odense, Denmark, and Aarhus University Hospital and Aarhus University Aarhus N Denmark
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23
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Krabbe S, Østergaard M, Pedersen SJ, Weber U, Kröber G, Makysmowych W, Lambert RGW. Canada-Denmark MRI scoring system of the spine in patients with axial spondyloarthritis: updated definitions, scoring rules and inter-reader reliability in a multiple reader setting. RMD Open 2019; 5:e001057. [PMID: 31673422 PMCID: PMC6803003 DOI: 10.1136/rmdopen-2019-001057] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 01/14/2023] Open
Abstract
Objective To validate the Canada-Denmark (CANDEN) MRI scoring system for the spine in axial spondyloarthritis with updated lesion definitions. Methods Lesion definitions in the CANDEN system were updated and illustrated by a consensus set of reference images. Sagittal spine MRIs of 40 patients with axial spondyloarthritis obtained at baseline and at week 52 after initiation of treatment with the tumour necrosis factor inhibitor golimumab were evaluated in unknown chronology by seven readers blinded to all other data. Results CANDEN MRI spine inflammation score had very good reliability for status scores (single-measure intraclass correlation coefficient (ICC) of 21 reader pairs median of 0.91 (IQR 0.88-0.92)) and change scores (ICC 0.88 (0.86-0.92)). CANDEN MRI spine fat score had good to very good reliability for status scores (ICC 0.79 (0.75-0.86)) and moderate to good reliability for detecting change (ICC 0.59 (0.46-0.73)). CANDEN MRI spine bone erosion score and CANDEN MRI spine new bone formation score had slight to moderate reliability for status scores (ICC 0.38 (0.32-0.52) and 0.39 (0.27-0.49), respectively). Conclusion The CANDEN MRI spine scoring system allows a comprehensive evaluation of inflammation, fat, bone erosion and new bone formation of the spine in patients with axial spondyloarthritis. It demonstrated very good reliability for detecting change in inflammation, moderate to good reliability for detecting change in fat, and slight to moderate reliability for detecting bone erosions and new bone formation. Studies with longer follow-up or patients with more advanced spinal involvement may be needed to reliably detect change in bone erosion and new bone formation scores. Trial registration number NCT02011386.
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Affiliation(s)
- Simon Krabbe
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ulrich Weber
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark.,Department of Regional Health Research, University Hospital of Southern Denmark, Odense, Denmark
| | - Georg Kröber
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark
| | - Walter Makysmowych
- CaRE Arthritis, Edmonton, Alberta, Canada.,Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Robert G W Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.,Medical Imaging Consultants, Edmonton, Alberta, Canada
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Castro MP, Stebbings SM, Milosavljevic S, Pedersen SJ, Bussey MD. Assessing the construct validity of clinical tests to identify sacroiliac joint inflammation in patients with non‐radiographic axial spondyloarthritis. Int J Rheum Dis 2019; 22:1521-1528. [DOI: 10.1111/1756-185x.13606] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/30/2019] [Accepted: 04/30/2019] [Indexed: 01/13/2023]
Affiliation(s)
- Marcelo P. Castro
- School of Physical Education, Sport and Exercise Science University of Otago Dunedin New Zealand
- Department of Medicine, Dunedin School of Medicine University of Otago Dunedin New Zealand
- Neuromusculoskeletal Rehabilitation and Clinical Biomechanics Laboratory – LaBClin Florianópolis Brazil
| | - Simon M. Stebbings
- Department of Medicine, Dunedin School of Medicine University of Otago Dunedin New Zealand
- Department of Rheumatology Dunedin Hospital Dunedin New Zealand
| | - Stephan Milosavljevic
- School of Rehabilitation Science University of Saskatchewan Saskatoon Saskatchewan Canada
| | - Susanne J. Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases Rigshospitalet Copenhagen Denmark
| | - Melanie D. Bussey
- School of Physical Education, Sport and Exercise Science University of Otago Dunedin New Zealand
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Jaremko JL, Lambert RG, Pedersen SJ, Weber U, Lindsay D, Al-Ani Z, Steer K, Pianta M, Wichuk S, Maksymowych WP. OMERACT Hip Inflammation Magnetic Resonance Imaging Scoring System (HIMRISS) Assessment in Longitudinal Study. J Rheumatol 2019; 46:1239-1242. [DOI: 10.3899/jrheum.181043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2018] [Indexed: 11/22/2022]
Abstract
Objective.To assess reliability, feasibility, and responsiveness of Hip Inflammation Magnetic resonance imaging Scoring System (HIMRISS) for bone marrow lesions (BML) in hip osteoarthritis (OA).Methods.HIMRISS was scored by 8 readers in 360 hips of 90 patients imaged pre/post-hip steroid injection. Pre-scoring, new readers trained online to achieve intraclass correlation coefficient (ICC) > 0.80 versus experts.Results.HIMRISS reliability was excellent for BML status (ICC 0.83–0.92). Despite small changes post-injection, reliability of BML change scores was high in femur (0.76–0.81) and moderate in acetabulum (0.42–0.56).Conclusion.HIMRISS should be a priority for further assessment of hip BML in OA, and evaluated for use in other arthropathies.
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Krabbe S, Eshed I, Gandjbakhch F, Pedersen SJ, Bird P, Mathew AJ, Lambert RG, Maksymowych WP, Glinatsi D, Stoenoiu MS, Poggenborg R, Jans L, Jaremko JL, Herregods N, Foltz V, Conaghan PG, Althoff CE, Paschke J, Peterfy C, Hermann KGA, Østergaard M. Development and Validation of an OMERACT MRI Whole-Body Score for Inflammation in Peripheral Joints and Entheses in Inflammatory Arthritis (MRI-WIPE). J Rheumatol 2019; 46:1215-1221. [PMID: 30770508 DOI: 10.3899/jrheum.181084] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To develop a whole-body magnetic resonance imaging (MRI) scoring system for peripheral arthritis and enthesitis. METHODS After consensus on definitions/locations of MRI pathologies, 4 multireader exercises were performed. Eighty-three joints were scored 0-3 separately for synovitis and osteitis, and 33 entheses 0-3 separately for soft tissue inflammation and osteitis. RESULTS In the last exercise, reliability was moderate-good for musculoskeletal radiologists and rheumatologists with previously demonstrated good scoring proficiency. Median pairwise single-measure/average-measure ICC were 0.67/0.80 for status scores and 0.69/0.82 for change scores; κ ranged 0.35-0.77. CONCLUSION Whole-body MRI scoring of peripheral arthritis and enthesitis is reliable, which encourages further testing and refinement in clinical trials.
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Affiliation(s)
- Simon Krabbe
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA. .,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen.
| | - Iris Eshed
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Frédérique Gandjbakhch
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Susanne J Pedersen
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Paul Bird
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Ashish J Mathew
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Robert G Lambert
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Walter P Maksymowych
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Daniel Glinatsi
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Maria S Stoenoiu
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - René Poggenborg
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Lennart Jans
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Jacob L Jaremko
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Nele Herregods
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Violaine Foltz
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Philip G Conaghan
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Christian E Althoff
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Joel Paschke
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Charles Peterfy
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Kay-Geert A Hermann
- From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS); AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Radiology and Diagnostic Imaging, and Department of Medicine, University of Alberta; CaRE Arthritis, Edmonton, Canada; Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Radiology, Ghent University Hospital, Ghent, Belgium; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospital National Health Service (NHS) Trust, UK; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Spire Sciences Inc., Boca Raton, Florida, USA.,S. Krabbe, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; I. Eshed, MD, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; P. Bird, MD, PhD, Division of Medicine, University of New South Wales; A.J. Mathew, MD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Clinical Immunology and Rheumatology, Christian Medical College; R.G. Lambert, MD, Department of Radiology and Diagnostic Imaging, University of Alberta; W.P. Maksymowych, MD, CaRE Arthritis, and Department of Medicine, University of Alberta; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Department of Rheumatology, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; R. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; L. Jans, MD, PhD, Department of Radiology, Ghent University Hospital; J.L. Jaremko, MD, PhD, Department of Radiology and Diagnostic Imaging, University of Alberta; N. Herregods, MD, PhD, Department of Radiology, Ghent University Hospital; V. Foltz, MD, University Pierre et Marie Curie - Paris 6, Sorbonne Universités, GRC-08 (EEMOIS), and AP-HP, Rheumatology Department, Pitié Salpêtrière University Hospital; P.G. Conaghan, MD, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospital NHS Trust; C.E. Althoff, MD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; J. Paschke, BSc, CaRE Arthritis; C. Peterfy, MD, PhD, Spire Sciences Inc.; K.A. Hermann, MD, PhD, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; M. Østergaard, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
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Mathew AJ, Krabbe S, Eshed I, Gandjbakhch F, Bird P, Pedersen SJ, Stoenoiu MS, Foltz V, Glinatsi D, Lambert RG, Hermann KGA, Maksymowych WP, Haugen IK, Jaremko JL, Poggenborg RP, Paschke J, Laredo JD, Carron P, Conaghan PG, Østergaard M. The OMERACT MRI in Enthesitis Initiative: Definitions of Key Pathologies, Suggested MRI Sequences, and a Novel Heel Enthesitis Scoring System. J Rheumatol 2019; 46:1232-1238. [PMID: 30709961 DOI: 10.3899/jrheum.181093] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To develop and validate an enthesitis magnetic resonance imaging (MRI) scoring system for spondyloarthritis/psoriatic arthritis, using the heel as model. METHODS Consensus definitions of key pathologies and 3 heel enthesitis multireader scoring exercises were done, separated by discussion, training, and calibration. RESULTS Definitions for bone and soft tissue pathologies were agreed. In the final exercise, median pairwise single-measures intraclass correlation coefficients (ICC; patient-level) for entheseal inflammation status/change scores were 0.83/0.82 for all readers. For radiologists and selected rheumatologists, ICC were 0.91/0.84 and quadratic-weighted κ (lesion-level) 0.57-0.91/0.45-0.81. CONCLUSION The proposed definitions and Heel Enthesitis Scoring System (HEMRIS) are reliable among trained readers and promising for clinical trials.
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Affiliation(s)
- Ashish J Mathew
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Simon Krabbe
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Iris Eshed
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Frédérique Gandjbakhch
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Paul Bird
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Susanne J Pedersen
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Maria S Stoenoiu
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Violaine Foltz
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Daniel Glinatsi
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Robert G Lambert
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Kay Geert A Hermann
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Walter P Maksymowych
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Ida K Haugen
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Jacob L Jaremko
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - René P Poggenborg
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Joel Paschke
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Jean-Denis Laredo
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Philippe Carron
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Philip G Conaghan
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK.,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen
| | - Mikkel Østergaard
- From the Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hôpitaux Universitaires Pitié Salpêtrière; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot, Paris, France; Division of Medicine, University of New South Wales, Sydney, Australia; Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Department of Radiology and Diagnostic Imaging, and CaRE (Canadian Research Education) Arthritis and Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité, Berlin, Germany; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Faculty of Medicine and Health, University of Leeds, Leeds, UK. .,A.J. Mathew, MBBS, DNB, DM, Associate Professor, Department of Clinical Immunology and Rheumatology, Christian Medical College, and PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; S. Krabbe, MD, PhD Fellow, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen; I. Eshed, MD, Professor, Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University; F. Gandjbakhch, MD, Practicing Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière, Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health; P. Bird, B Med (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of New South Wales; S.J. Pedersen, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; M.S. Stoenoiu, MD, PhD, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain; V. Foltz, MD, Practising Rheumatologist, Hôpitaux Universitaires Pitié Salpêtrière; D. Glinatsi, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; R.G. Lambert, MB.BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; K.G. Hermann, MD, PhD, Senior Consultant, Department of Radiology, Arthritis Imaging Research Group, University Hospital Charité; W.P. Maksymowych MD, FRCP(C), Professor, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; J.L. Jaremko, MD, PhD, FRCPC, Associate Professor, Department of Radiology, University of Alberta; R.P. Poggenborg, MD, PhD, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet; J. Paschke, BSc, CaRE (Canadian Research Education) Arthritis; J.D. Laredo, MD, Professor, Service de Radiologie, Hôpital Lariboisière, AP-HP and Université Paris-Diderot; P. Carron, MD, PhD, Department of Rheumatology, Ghent University Hospital; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service Trust; M. Østergaard, MD, PhD, DMSc, Professor, Department of Clinical Medicine, Faculty of Health and Medical Sciences, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, University of Copenhagen.
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Pedersen SJ, Weber U, Said-Nahal R, Sørensen IJ, Loft AG, Kollerup G, Juul L, Frandsen PB, Thamsborg G, Madsen OR, Møller J, Balding L, Jurik AG, Østergaard M. Structural progression rate decreases over time on serial radiography and magnetic resonance imaging of sacroiliac joints and spine in a five-year follow-up study of patients with ankylosing spondylitis treated with tumour necrosis factor inhibitor. Scand J Rheumatol 2018; 48:185-197. [PMID: 30422733 DOI: 10.1080/03009742.2018.1506822] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate temporal changes in structural progression assessed by serial conventional radiography and magnetic resonance imaging (MRI) of the sacroiliac joints (SIJs) and spine in patients with ankylosing spondylitis (AS) treated with tumour necrosis factor (TNF) inhibitor for 5 years. METHOD Forty-two patients were included and 33 patients were followed for 5 years in a prospective investigator-initiated study. Conventional radiographs were required four times and MRI seven times. The modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS); Spondyloarthritis Research Consortium of Canada (SPARCC) MRI SIJ and Spine Inflammation, and SPARCC MRI SIJ Structural Score (SSS) for Fat, Erosion, Backfill, and Ankylosis; and the Canada-Denmark MRI scores for Spine Inflammation, Fat, Erosion, and New Bone Formation (NBF) were applied. RESULTS Compared with baseline, MRI Inflammation had decreased significantly at week 22 (spine)/week 46 (SIJ) and thereafter. MRI SIJ Fat (from week 22), SIJ Ankylosis, Spine NBF, and mSASSS had increased significantly at week 46 and thereafter. SIJ Erosion had decreased from year 2. The annual progression rate in mSASSS was significantly higher during weeks 0-46 compared to week 46 to year 3. In multivariate regression analyses, baseline SIJ Inflammation and Backfill were independent predictors of 5 year progression in SIJ Ankylosis. Spine Erosion predicted progression in Spine NBF. Longitudinally, Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Disease Activity Index, MRI Spine Inflammation, Fat, and Erosion scores were significantly associated with mSASSS. SIJ Inflammation, Fat, Erosion, and Backfill scores were longitudinally associated with SIJ Ankylosis. Structural progression was not associated with body mass index, smoking, or Assessment of SpondyloArthritis international Society Non-Steroidal Anti-Inflammatory Drug Index. CONCLUSION In a 5 year follow-up study of patients with AS treated with TNF inhibitor, structural progression decreased over time.
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Affiliation(s)
- S J Pedersen
- a Center for Rheumatology and Spine Diseases , Rigshospitalet , Copenhagen , Denmark.,b COPECARE, Copenhagen Center for Arthritis Research , Rigshospitalet , Copenhagen , Denmark
| | - U Weber
- c Department of Rheumatology , King Christian X Hospital, Gråsten and University of Southern Denmark , Odense , Denmark
| | - R Said-Nahal
- d Department of Rheumatology , Versailles Saint Quentin University, Ambroise-Paré Hospital , Paris , France
| | - I J Sørensen
- a Center for Rheumatology and Spine Diseases , Rigshospitalet , Copenhagen , Denmark.,b COPECARE, Copenhagen Center for Arthritis Research , Rigshospitalet , Copenhagen , Denmark.,e Department of Clinical Medicine , University of Copenhagen , Copenhagen , Denmark
| | - A G Loft
- f Department of Rheumatology , Hospital Lillebælt , Vejle , Denmark.,g Department of Rheumatology , Aarhus University Hospital , Aarhus , Denmark
| | - G Kollerup
- a Center for Rheumatology and Spine Diseases , Rigshospitalet , Copenhagen , Denmark
| | - L Juul
- a Center for Rheumatology and Spine Diseases , Rigshospitalet , Copenhagen , Denmark
| | - P B Frandsen
- a Center for Rheumatology and Spine Diseases , Rigshospitalet , Copenhagen , Denmark
| | - G Thamsborg
- a Center for Rheumatology and Spine Diseases , Rigshospitalet , Copenhagen , Denmark
| | - O R Madsen
- a Center for Rheumatology and Spine Diseases , Rigshospitalet , Copenhagen , Denmark
| | - J Møller
- h Department of Radiology , Herlev Hospital , Copenhagen , Denmark
| | - L Balding
- h Department of Radiology , Herlev Hospital , Copenhagen , Denmark
| | - A G Jurik
- i Department of Radiology , Aarhus University Hospital , Aarhus , Denmark.,j Department of Clinical Medicine , Aarhus University , Aarhus , Denmark
| | - M Østergaard
- a Center for Rheumatology and Spine Diseases , Rigshospitalet , Copenhagen , Denmark.,b COPECARE, Copenhagen Center for Arthritis Research , Rigshospitalet , Copenhagen , Denmark.,c Department of Rheumatology , King Christian X Hospital, Gråsten and University of Southern Denmark , Odense , Denmark
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Krabbe S, Sørensen IJ, Jensen B, Møller JM, Balding L, Madsen OR, Lambert RGW, Maksymowych WP, Pedersen SJ, Østergaard M. Inflammatory and structural changes in vertebral bodies and posterior elements of the spine in axial spondyloarthritis: construct validity, responsiveness and discriminatory ability of the anatomy-based CANDEN scoring system in a randomised placebo-controlled trial. RMD Open 2018; 4:e000624. [PMID: 29556419 PMCID: PMC5856914 DOI: 10.1136/rmdopen-2017-000624] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/29/2018] [Accepted: 02/15/2018] [Indexed: 12/22/2022] Open
Abstract
Background The Canada-Denmark (CANDEN) definitions of spinal MRI lesions allow a detailed anatomy-based evaluation of inflammatory and structural lesions in vertebral bodies and posterior elements of the spine in patients with axial spondyloarthritis (axSpA). The objective was to examine the reliability, responsiveness and discrimination of scores for spinal inflammation, fat, bone erosion and new bone formation based on the CANDEN system and to describe patterns of inflammatory and structural lesions and their temporal development. Methods 49 patients with axSpA from an investigator-initiated, randomised, placebo-controlled trial of adalimumab underwent spinal MRI at weeks 0/6/24/48. MR images were scored according to the CANDEN system and the Spondyloarthritis Research Consortium of Canada (SPARCC) method. Total scores, and various subscores, were created by summing individual lesion scores. Results The CANDEN spine inflammation score had high responsiveness, similar to the SPARCC MRI spine index (Guyatt’s responsiveness index 1.88 and 1.67, respectively), and discriminated between adalimumab and placebo treatment already at 6 weeks’ follow-up (P=0.03). Anterior/posterior corner inflammation subscores showed similar responsiveness. Inter-reader reliability for the CANDEN spine inflammation and fat scores was good to very good for status and change scores (intraclass correlation coefficient (ICC)=0.71–0.92). Reliability for CANDEN new bone formation and erosion scores was good to very good for status scores (ICC=0.61–0.75) but, due to minimal progression, poor for change scores (ICC≤0.40). Conclusions The CANDEN spine inflammation score showed good responsiveness, discrimination between active treatment and placebo and reliability. The CANDEN spine structural scores had good cross-sectional reliability, but longer studies are needed to investigate their sensitivity to change. Trial registration number NCT01029847; Results.
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Affiliation(s)
- Simon Krabbe
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Inge J Sørensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bente Jensen
- Center for Rheumatology and Spine Diseases, Frederiksberg and Bispebjerg Hospitals, Copenhagen, Denmark
| | - Jakob M Møller
- Department of Radiology, Herlev and Gentofte Hospitals, Herlev, Denmark
| | - Lone Balding
- Department of Radiology, Herlev and Gentofte Hospitals, Herlev, Denmark
| | - Ole R Madsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Center for Rheumatology and Spine Diseases, Herlev and Gentofte Hospitals, Herlev, Denmark
| | - Robert G W Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | | | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Center for Rheumatology and Spine Diseases, Herlev and Gentofte Hospitals, Herlev, Denmark
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Krabbe S, Østergaard M, Eshed I, Sørensen IJ, Jensen B, Møller JM, Balding L, Madsen OR, Asmussen K, Eng G, Jørgensen NR, Pedersen SJ. Whole-body Magnetic Resonance Imaging in Axial Spondyloarthritis: Reduction of Sacroiliac, Spinal, and Entheseal Inflammation in a Placebo-controlled Trial of Adalimumab. J Rheumatol 2018; 45:621-629. [DOI: 10.3899/jrheum.170408] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2017] [Indexed: 12/29/2022]
Abstract
Objective.To investigate whether adalimumab (ADA) reduces whole-body (WB-) magnetic resonance imaging (MRI) indices for inflammation in the entheses, peripheral joints, sacroiliac joints, spine, and the entire body in patients with axial spondyloarthritis (axSpA).Methods.An investigator-initiated, randomized, placebo-controlled, double-blinded 48-week followup trial included 49 patients with axSpA, who had Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4.0 despite treatment with nonsteroidal antiinflammatory drugs and a clinical indication for tumor necrosis factor inhibitor treatment. Patients were randomized to subcutaneous ADA 40 mg or placebo every other week for 6 weeks; thereafter, all patients received ADA. Conventional MRI and WBMRI were performed at weeks 0, 6, 24, and 48. The primary WBMRI endpoint was the proportion of patients with an improvement in WBMRI total inflammation index above the smallest detectable change (SDC) at Week 6.Results.The primary WBMRI endpoint (improvement of SDC > 2.3) was met in 11 (44%) patients in the ADA group and 3 (13%) patients in the placebo group (p = 0.025, Fisher’s exact test). The primary conventional MRI endpoint, the minimally important change in Spondyloarthritis Research Consortium of Canada Spine MRI Inflammation Index at Week 6, was achieved by 9 (36%) patients in the ADA group and 4 (17%) patients in the placebo group (p = 0.20). The primary clinical endpoint, BASDAI reduction > 50% or 2.0 at Week 24, was attained by 32 (65%) patients.Conclusion.ADA provided significant reductions in WBMRI indices of peripheral, axial, and whole-body inflammation in patients with axSpA. WBMRI is promising for objective assessment and monitoring of peripheral and axial disease activity in future clinical trials.
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Chronaiou I, Thomsen RS, Huuse EM, Euceda LR, Pedersen SJ, Hoff M, Sitter B. Quantifying bone marrow inflammatory edema in the spine and sacroiliac joints with thresholding. BMC Musculoskelet Disord 2017; 18:497. [PMID: 29179748 PMCID: PMC5704357 DOI: 10.1186/s12891-017-1861-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 11/20/2017] [Indexed: 11/13/2022] Open
Abstract
Background Psoriatic Arthritis (PsA) is a chronic inflammatory arthritis that develops in patients with psoriasis. Inflammatory edema in the spine may reflect subclinical disease activity and be a predictor of radiographic progression. A semi-quantitative method established by the spondyloarthritis research consortium of Canada (SPARCC) is commonly used to assess the disease activity in MR images of the spine. This study aims to evaluate thresholding for quantification of subtle bone marrow inflammation in the spine and the sacroiliac (SI) joints of patients with PsA and compare it with the SPARCC scoring system. Methods Short tau inversion recovery (STIR) MR images of the spine (N = 85) and the SI joints (N = 95) of patients with PsA (N = 41) were analyzed. A threshold was applied to visible bone marrow in order to mask areas with higher signal intensity, which are consistent with inflammation. These areas were considered as inflammatory lesions. The volume and relative signal intensity of the lesions were calculated. Results from thresholding were compared to SPARCC scores using linear mixed-effects models. The specificity and sensitivity of thresholding were also calculated. Results A significant positive correlation between the volumes and mean relative signal intensities, which were calculated by thresholding analysis, and the SPARCC scores was detected for both spine (p < 0.001) and SI joints (p < 0.001). For the spine, thresholding had sensitivity and specificity of 83% and 76% respectively, while for the SI joints the values were 51% and 88% respectively. Conclusions Thresholding allows quantification of subtle bone marrow inflammatory edema in patients with psoriatic arthritis, and could support SPARCC scoring of the spine. Improved image processing and inclusion of automatic segmentation are required for thresholding of STIR images to become a rapid and reliable method for quantitative measures of inflammation. Trial registration NCT02995460 (December 14, 2016) – Retrospectively registered.
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Affiliation(s)
- Ioanna Chronaiou
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, 7491 Trondheim, Norway, Trondheim, Norway.
| | - Ruth S Thomsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Else M Huuse
- Department of Radiology and Nuclear Medicine, St Olav's Hospital, University Hospital in Trondheim, Trondheim, Norway
| | - Leslie R Euceda
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, 7491 Trondheim, Norway, Trondheim, Norway
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet - Glostrup, Copenhagen, Denmark
| | - Mari Hoff
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Department of Rheumatology, St Olav's Hospital, University Hospital in Trondheim, Trondheim, Norway
| | - Beathe Sitter
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, 7491 Trondheim, Norway, Trondheim, Norway
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Østergaard M, Eshed I, Althoff CE, Poggenborg RP, Diekhoff T, Krabbe S, Weckbach S, Lambert RGW, Pedersen SJ, Maksymowych WP, Peterfy CG, Freeston J, Bird P, Conaghan PG, Hermann KGA. Whole-body Magnetic Resonance Imaging in Inflammatory Arthritis: Systematic Literature Review and First Steps Toward Standardization and an OMERACT Scoring System. J Rheumatol 2017; 44:1699-1705. [PMID: 28620061 DOI: 10.3899/jrheum.161114] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Whole-body magnetic resonance imaging (WB-MRI) is a relatively new technique that can enable assessment of the overall inflammatory status of people with arthritis, but standards for image acquisition, definitions of key pathologies, and a quantification system are required. Our aim was to perform a systematic literature review (SLR) and to develop consensus definitions of key pathologies, anatomical locations for assessment, a set of MRI sequences and imaging planes for the different body regions, and a preliminary scoring system for WB-MRI in inflammatory arthritis. METHODS An SLR was initially performed, searching for WB-MRI studies in arthritis, osteoarthritis, spondyloarthritis, or enthesitis. These results were presented to a meeting of the MRI in Arthritis Working Group together with an MR image review. Following this, preliminary standards for WB-MRI in inflammatory arthritides were developed with further iteration at the Working Group meetings at the Outcome Measures in Rheumatology (OMERACT) 2016. RESULTS The SLR identified 10 relevant original articles (7 cross-sectional and 3 longitudinal, mostly focusing on synovitis and/or enthesitis in spondyloarthritis, 4 with reproducibility data). The Working Group decided on inflammation in peripheral joints and entheses as primary focus areas, and then developed consensus MRI definitions for these pathologies, selected anatomical locations for assessment, agreed on a core set of MRI sequences and imaging planes for the different regions, and proposed a preliminary scoring system. It was decided to test and further develop the system by iterative multireader exercises. CONCLUSION These first steps in developing an OMERACT WB-MRI scoring system for use in inflammatory arthritides offer a framework for further testing and refinement.
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Affiliation(s)
- Mikkel Østergaard
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia. .,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School.
| | - Iris Eshed
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Christian E Althoff
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Rene P Poggenborg
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Torsten Diekhoff
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Simon Krabbe
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Sabine Weckbach
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Robert G W Lambert
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Susanne J Pedersen
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Walter P Maksymowych
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Charles G Peterfy
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Jane Freeston
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Paul Bird
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Philip G Conaghan
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
| | - Kay-Geert A Hermann
- From the Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Arthritis Imaging Research Group, Department of Radiology, Charité Medical School, Berlin; Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; Department of Radiology and Diagnostic Imaging, and Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Spire Sciences Inc., Boca Raton, Florida, USA; St. James' University and Chapel Allerton Hospitals; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of New South Wales (NSW), Sydney, Australia.,M. Østergaard, MD, PhD, DMSc, Professor, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet, and Department of Clinical Medicine, University of Copenhagen; I. Eshed, MD, Associate Professor, Department of Diagnostic Imaging, The Sheba Medical Center, Sackler School of Medicine; C.E. Althoff, MD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; R.P. Poggenborg, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; T. Diekhoff, MD, Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School; S. Krabbe, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; S. Weckbach, MD, Professor of Radiology, Diagnostic and Interventional Radiology, University Hospital Heidelberg; R.G. Lambert, MB, BCh, FRCR, FRCPC, Professor, Department of Radiology and Diagnostic Imaging, University of Alberta; S.J. Pedersen, MD, PhD, COPECARE, Center for Rheumatology and Spine Diseases, Rigshospitalet; W.P. Maksymowych, MB, ChB, FRCP(C), Professor, FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; C.G. Peterfy, MD, PhD, FRCP, Chief Executive Officer, Spire Sciences Inc.; J. Freeston, MD, PhD, Consultant Rheumatologist and Honorary Clinical Associate Professor, St. James' University and Chapel Allerton Hospitals; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Associate Professor, University of NSW; P.G. Conaghan, MB, BS, PhD, FRACP, FRCP, Professor of Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Musculoskeletal Biomedical Research Unit; K.G. Hermann, MD, PhD, Senior Consultant, Arthritis Imaging Research Group, Department of Radiology, Charité Medical School
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Maksymowych WP, Wichuk S, Chiowchanwisawakit P, Lambert RG, Pedersen SJ. Fat metaplasia on MRI of the sacroiliac joints increases the propensity for disease progression in the spine of patients with spondyloarthritis. RMD Open 2017; 3:e000399. [PMID: 28469937 PMCID: PMC5387982 DOI: 10.1136/rmdopen-2016-000399] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 01/13/2017] [Accepted: 02/24/2017] [Indexed: 01/06/2023] Open
Abstract
Objective We tested the hypothesis that fat metaplasia on MRI of the sacroiliac joints (SIJ) increases the propensity for new bone formation in the spine of patients with spondyloarthritis. Methods We assessed baseline T1-weighted and short τ inversion recovery SIJ MRIs from patients in the Follow Up Research Cohort in Ankylosing Spondylitis (FORCAST). Radiographic progression was assessed using the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Structural and inflammatory lesions were scored using the Spondyloarthritis Research Consortium of Canada (SPARCC) SIJ structural and SPARCC SIJ inflammation scores, respectively. Radiographic progression was compared in cases with and without definite MRI lesions (score ≥2 or <2) and the extent of MRI lesions at baseline was compared in patients with and without radiographic progression. The predictive capacity of MRI SIJ lesions for radiographic progression in the spine was assessed in univariate and multivariate regression analyses. Results The extent of MRI structural lesions in the SIJ at baseline was significantly greater in those patients who had spinal radiographic progression on follow-up (p=0.003, 0.02, 0.003 for fat metaplasia, backfill and ankylosis, respectively). Also, radiographic progression was significantly greater in cases with definite baseline SIJ ankylosis (p=0.008). In multivariate regression that included all types of MRI lesions and was adjusted for age, sex, symptom duration, duration of follow-up, CRP, baseline mSASSS and treatment, the extent of SIJ fat metaplasia and ankylosis at baseline were independently associated with radiographic progression. Conclusions SIJ ankylosis and fat metaplasia but not inflammatory lesions increase the propensity for radiographic progression in the spine.
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Affiliation(s)
- W P Maksymowych
- Department of Medicine, Spondyloarthritis Research Consortium of Canada Center, University of Alberta, Edmonton, Alberta, Canada
| | - S Wichuk
- Department of Medicine, Spondyloarthritis Research Consortium of Canada Center, University of Alberta, Edmonton, Alberta, Canada
| | | | - R G Lambert
- Department of Radiology and Diagnostic Imaging, Spondyloarthritis Research Consortium of Canada Center, University of Alberta, Edmonton, Alberta, Canada
| | - S J Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
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Axelsen MB, Eshed I, Østergaard M, Hetland ML, Møller JM, Jensen DV, Krintel SB, Hansen MS, Terslev L, Klarlund M, Poggenborg RP, Balding L, Pedersen SJ. Monitoring total-body inflammation and damage in joints and entheses: the first follow-up study of whole-body magnetic resonance imaging in rheumatoid arthritis. Scand J Rheumatol 2017; 46:253-262. [PMID: 28125360 DOI: 10.1080/03009742.2016.1231338] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To investigate changes in whole-body magnetic resonance imaging (WBMRI) inflammatory and structural lesions in most joints and entheses in patients with rheumatoid arthritis (RA) treated with adalimumab. METHODS WBMRI was obtained at weeks 0, 6, 16, and 52 in a 52 week follow-up study of 37 RA patients starting treatment with adalimumab. Readability and reliability of WBMRI were investigated for 76 peripheral joints, 23 discovertebral units, the sacroiliac joints, and 33 entheses. Changes in WBMRI joint and entheses counts were investigated. RESULTS The readability of peripheral and axial joints was 82-100%, being less for elbows and small joints of the feet. For entheses, 72-100% were readable, except for entheses at the anterior chest wall, elbow, knee, and plantar fascia. The intrareader agreement was high for bone marrow oedema (BMO), bone erosion (80-100%), and enthesitis (77-100%), and slightly lower for synovitis and soft tissue inflammation (50-100%). All synovitis, BMO, and soft tissue inflammation counts decreased numerically during treatment. The 26-joint synovitis WBMRI count decreased significantly during the first 16 weeks for patients with a good European League Against Rheumatism (EULAR) response (from median 6 to 4, p < 0.05), but not for patients with a moderate or no EULAR response. There were no overall changes in structural lesions. CONCLUSIONS WBMRI allows simultaneous monitoring of most axial and peripheral joints and entheses in RA patients and can visualize a decrease in inflammatory counts during treatment. This first WBMRI follow-up study of patients with RA encourages further investigation of the usefulness of WBMRI in RA.
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Affiliation(s)
- M B Axelsen
- a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark
| | - I Eshed
- b Department of Diagnostic Imaging, Sheba Medical Center , Tel Aviv University , Tel Giborim , Israel
| | - M Østergaard
- a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark.,c Department of Clinical Medicine, Faculty of Health Sciences , University of Copenhagen , Copenhagen , Denmark
| | - M L Hetland
- a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark.,c Department of Clinical Medicine, Faculty of Health Sciences , University of Copenhagen , Copenhagen , Denmark
| | - J M Møller
- d Department of Radiology , Herlev Hospital, University of Copenhagen , Herlev , Denmark
| | - D V Jensen
- e Center for Rheumatology and Spine Diseases, Nordsjællands Hospital Hillerød , University of Copenhagen , Hillerød , Denmark
| | - S B Krintel
- a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark
| | - M S Hansen
- f Center for Rheumatology and Spine Diseases , University of Copenhagen , Gentofte , Denmark
| | - L Terslev
- a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark
| | - M Klarlund
- a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark
| | - R P Poggenborg
- a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark
| | - L Balding
- d Department of Radiology , Herlev Hospital, University of Copenhagen , Herlev , Denmark
| | - S J Pedersen
- a Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases , Rigshospitalet - Glostrup , Glostrup , Denmark
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Hermansen LT, Loft AG, Christiansen AA, Munk HL, Gilbert L, Jurik AG, Arnbak B, Manniche C, Weber U, Østergaard M, Pedersen SJ, Barington T, Junker P, Hørslev-Petersen K, Hendricks O. No diagnostic utility of antibody patterns against Klebsiella pneumoniae capsular serotypes in patients with axial spondyloarthritis vs. patients with non-specific low back pain: a cross-sectional study. Scand J Rheumatol 2016; 46:296-302. [DOI: 10.1080/03009742.2016.1205659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- LT Hermansen
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - AG Loft
- Department of Medicine, Hospital Lillebælt, Vejle, Denmark
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - AA Christiansen
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - HL Munk
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - L Gilbert
- Department of Biology and Environmental Science and NanoScience Centre, University of Jyväskylä, Jyväskylä, Finland
| | - AG Jurik
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
- Research Department, Spine Centre of Southern Denmark, Hospital Lillebælt, Middelfart, Denmark
| | - B Arnbak
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Research Department, Spine Centre of Southern Denmark, Hospital Lillebælt, Middelfart, Denmark
| | - C Manniche
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Research Department, Spine Centre of Southern Denmark, Hospital Lillebælt, Middelfart, Denmark
| | - U Weber
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - M Østergaard
- Copenhagen Centre for Arthritis Research, Centre for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Copenhagen, Denmark
| | - SJ Pedersen
- Copenhagen Centre for Arthritis Research, Centre for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Copenhagen, Denmark
| | - T Barington
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - P Junker
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - K Hørslev-Petersen
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - O Hendricks
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Pedersen SJ, Poddubnyy D, Sørensen IJ, Loft AG, Hindrup JS, Thamsborg G, Asmussen K, Hendricks O, Nørregaard J, Piil AD, Møller JM, Jurik AG, Balding L, Lambert RG, Sieper J, Østergaard M. Course of Magnetic Resonance Imaging-Detected Inflammation and Structural Lesions in the Sacroiliac Joints of Patients in the Randomized, Double-Blind, Placebo-Controlled Danish Multicenter Study of Adalimumab in Spondyloarthritis, as Assessed by the Berlin and Spondyloarthritis Research Consortium of Canada Methods. Arthritis Rheumatol 2016; 68:418-29. [PMID: 26414004 DOI: 10.1002/art.39434] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 09/08/2015] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To investigate changes in magnetic resonance imaging (MRI)-assessed inflammation and structural lesions in the sacroiliac (SI) joints during treatment with adalimumab versus placebo. METHODS In a 48-week double-blind, placebo-controlled trial, 52 patients with spondyloarthritis were randomized to receive subcutaneous injections of either adalimumab 40 mg (n = 25) or placebo (n = 27) every other week for 12 weeks. Patients in the adalimumab group continued to receive and patients in the placebo group were switched to adalimumab 40 mg every other week for an additional 12 weeks. MRI of the SI joints was performed at weeks 0, 12, 24, and 48, and the images were assessed independently in a blinded manner using the modified Berlin and the Spondyloarthritis Research Consortium of Canada (SPARCC) MRI scores for inflammation and structural lesions of the SI joints. RESULTS At baseline, 56% of the adalimumab group and ∼72% of the placebo group had an MRI-assessed inflammation score of ≥1. Among the patients with inflammation at baseline, the mean percent reductions in MRI scores for inflammation from week 0 to 12 were greater in the adalimumab group compared with the placebo group (Berlin method, -62% versus -5%; SPARCC method, -58% versus -12% [both P < 0.04]). Furthermore, the mean SPARCC erosion score decreased (-0.6) and the SPARCC backfill score increased (+0.8) in the adalimumab group from week 0 to week 12. From week 12 to week 24, larger absolute reductions in the Berlin/SPARCC inflammation scores and the SPARCC erosion score and larger increases in the Berlin/SPARCC fatty lesion scores were seen in the placebo group compared with the adalimumab group. In univariate regression analyses (analysis of covariance) and multivariate stepwise regression analyses, treatment with adalimumab was independently associated with regression of the SPARCC erosion score from week 0 to 12 but not with changes in the other types of MRI lesions. CONCLUSION Significant changes in the Berlin and SPARCC MRI-assessed inflammation scores and in the SPARCC MRI-assessed erosion scores occurred within 12 weeks after initiation of adalimumab. Tumor necrosis factor inhibitor treatment was associated with resolution of erosions and the development of backfill.
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Affiliation(s)
- Susanne J Pedersen
- Rigshospitalet, University of Copenhagen Glostrup Hospital, University of Copenhagen Gentofte Hospital, and University of Copenhagen, Copenhagen, Denmark
| | - Denis Poddubnyy
- Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Inge J Sørensen
- Rigshospitalet, University of Copenhagen Glostrup Hospital and University of Copenhagen, Copenhagen, Denmark
| | - Anne-Gitte Loft
- Sygehus Lillebaelt, Vejle, and Aarhus University Hospital, Noerrebrogade, Aarhus, Denmark
| | - Jens S Hindrup
- University of Copenhagen Gentofte Hospital and University of Copenhagen, Copenhagen, Denmark
| | - Gorm Thamsborg
- Rigshospitalet, University of Copenhagen Glostrup Hospital and University of Copenhagen, Copenhagen, Denmark
| | - Karsten Asmussen
- Bispebjerg and Frederiksberg Hospital and University of Copenhagen, Copenhagen, Denmark
| | - Oliver Hendricks
- King Christian 10th Hospital for Rheumatic Diseases, Graasten, Denmark
| | - Jesper Nørregaard
- Nordsjaellands Hospital, Hillerød, and University of Copenhagen, Copenhagen, Denmark
| | | | - Jakob M Møller
- University of Copenhagen Herlev Hospital, Herlev, Denmark
| | | | - Lone Balding
- University of Copenhagen Herlev Hospital, Herlev, Denmark
| | | | - Joachim Sieper
- Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Mikkel Østergaard
- Rigshospitalet, University of Copenhagen Glostrup Hospital and University of Copenhagen, Copenhagen, Denmark
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Arnbak B, Hendricks O, Hørslev-Petersen K, Jurik AG, Pedersen SJ, Østergaard M, Hermansen LT, Loft AG, Jensen TS, Manniche C. The discriminative value of inflammatory back pain in patients with persistent low back pain. Scand J Rheumatol 2016; 45:321-8. [DOI: 10.3109/03009742.2015.1105289] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- B Arnbak
- Research Department, Spine Centre of Southern Denmark, Hospital Lillebaelt, Middelfart, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - O Hendricks
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- King Christian X Hospital for Rheumatic Diseases, Graasten, Denmark
| | - K Hørslev-Petersen
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- King Christian X Hospital for Rheumatic Diseases, Graasten, Denmark
| | - AG Jurik
- Research Department, Spine Centre of Southern Denmark, Hospital Lillebaelt, Middelfart, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - SJ Pedersen
- Copenhagen Centre for Arthritis Research, Centre for Rheumatology and Spine Diseases, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - M Østergaard
- Copenhagen Centre for Arthritis Research, Centre for Rheumatology and Spine Diseases, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - LT Hermansen
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- King Christian X Hospital for Rheumatic Diseases, Graasten, Denmark
| | - AG Loft
- Department of Medicine, Hospital Lillebaelt, Vejle, Denmark
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - TS Jensen
- Research Department, Spine Centre of Southern Denmark, Hospital Lillebaelt, Middelfart, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - C Manniche
- Research Department, Spine Centre of Southern Denmark, Hospital Lillebaelt, Middelfart, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Weber U, Maksymowych WP, Chan SM, Rufibach K, Pedersen SJ, Zhao Z, Zubler V, Østergaard M, Lambert RGW. Does evaluation of the ligamentous compartment enhance diagnostic utility of sacroiliac joint MRI in axial spondyloarthritis? Arthritis Res Ther 2015; 17:246. [PMID: 26363915 PMCID: PMC4568071 DOI: 10.1186/s13075-015-0729-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/27/2015] [Indexed: 11/10/2022] Open
Abstract
Introduction Inflammation of the sacroiliac joints (SIJ) is a fundamental clinical feature of axial spondyloarthritis (SpA). The anatomy of the irregularly shaped SIJ is complex with an antero-inferior cartilaginous compartment containing central hyaline and peripheral fibrocartilage, and a dorso-superior ligamentous compartment. Several scoring modules to systematically assess SIJ magnetic resonance imaging (MRI) in SpA have been developed. Nearly all of them are based on the cartilaginous joint compartment alone. However, there are only limited data about the frequency of inflammatory lesions in the ligamentous compartment and their potential diagnostic utility in axial SpA. We therefore aimed to evaluate the ligamentous compartment on sacroiliac joint MRI for lesion distribution and potential incremental value towards diagnosis of SpA over and above the traditional assessment of the cartilaginous compartment alone. Methods Two independent cohorts of 69 and 88 consecutive back pain patients ≤50 years were referred for suspected SpA (cohort A) or acute anterior uveitis plus back pain (cohort B). Patients were classified according to rheumatologist expert opinion based on clinical, radiographic and laboratory examination as having nonradiographic axial SpA (nr-axSpA; n = 51), ankylosing spondylitis (n = 34), or nonspecific back pain (NSBP; n = 72). Five blinded readers assessed SIJ MRI globally for presence/absence of SpA. Bone marrow edema (BME) and fat metaplasia were recorded in the cartilaginous and ligamentous compartment. The incremental value of evaluating the ligamentous additionally to the cartilaginous compartment alone for diagnosis of SpA was graded qualitatively. We determined the lesion distribution between the two compartments, and the impact of the ligamentous compartment evaluation on diagnostic utility. Results MRI bone marrow lesions solely in the ligamentous compartment in the absence of lesions in the cartilaginous compartment were reported in just 0–2.0/0–4.0 % (BME/fat metaplasia) of all subjects. Additional assessment of the ligamentous compartment was regarded as essential for diagnosis in 0 and 0.6 %, and as contributory in 28.0 and 7.7 % of nr-axSpA patients in cohorts A and B, respectively. Concomitant BME in both compartments was evident in 11.6–42.0 % of nr-axSpA and 2.1–2.4 % of NSBP patients. Conclusion Assessing the ligamentous compartment on SIJ MRI provided no incremental value for diagnosis of axial SpA. However, concomitant BME in both compartments may help discriminate nr-axSpA from NSBP.
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Affiliation(s)
- Ulrich Weber
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, and Sygehus, Sønderjylland, Denmark. .,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark. .,Department of Rheumatology, Balgrist University Hospital, Zurich, Switzerland.
| | | | - Stanley M Chan
- Department of Ophthalmology, University of Alberta, Edmonton, Alberta, Canada.
| | - Kaspar Rufibach
- Rufibach rePROstat, Biostatistical Consulting and Training, Engelgasse 123, 4052, Basel, Switzerland.
| | - Susanne J Pedersen
- Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, and, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Zheng Zhao
- Department of Rheumatology, PLA General Hospital, Beijing, China.
| | - Veronika Zubler
- Department of Radiology, Balgrist University Hospital, Zurich, Switzerland.
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, and, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Robert G W Lambert
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
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Mandl P, Navarro-Compán V, Terslev L, Aegerter P, van der Heijde D, D'Agostino MA, Baraliakos X, Pedersen SJ, Jurik AG, Naredo E, Schueller-Weidekamm C, Weber U, Wick MC, Bakker PAC, Filippucci E, Conaghan PG, Rudwaleit M, Schett G, Sieper J, Tarp S, Marzo-Ortega H, Østergaard M. EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice. Ann Rheum Dis 2015; 74:1327-39. [DOI: 10.1136/annrheumdis-2014-206971] [Citation(s) in RCA: 300] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 03/07/2015] [Indexed: 12/26/2022]
Abstract
A taskforce comprised of an expert group of 21 rheumatologists, radiologists and methodologists from 11 countries developed evidence-based recommendations on the use of imaging in the clinical management of both axial and peripheral spondyloarthritis (SpA). Twelve key questions on the role of imaging in SpA were generated using a process of discussion and consensus. Imaging modalities included conventional radiography, ultrasound, magnetic resonance imaging, computed tomography (CT), positron emission tomography, single photon emission CT, dual-emission x-ray absorptiometry and scintigraphy. Experts applied research evidence obtained from systematic literature reviews using MEDLINE and EMBASE to develop a set of 10 recommendations. The strength of recommendations (SOR) was assessed by taskforce members using a visual analogue scale. A total of 7550 references were identified in the search process, from which 158 studies were included in the systematic review. Ten recommendations were produced using research-based evidence and expert opinion encompassing the role of imaging in making a diagnosis of axial SpA or peripheral SpA, monitoring inflammation and damage, predicting outcome, response to treatment, and detecting spinal fractures and osteoporosis. The SOR for each recommendation was generally very high (range 8.9–9.5). These are the first recommendations which encompass the entire spectrum of SpA and evaluate the full role of all commonly used imaging modalities. We aimed to produce recommendations that are practical and valuable in daily practice for rheumatologists, radiologists and general practitioners.
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Weber U, Zhao Z, Rufibach K, Zubler V, Lambert RGW, Chan SM, Østergaard M, Pedersen SJ, Maksymowych WP. Diagnostic Utility of Candidate Definitions for Demonstrating Axial Spondyloarthritis on Magnetic Resonance Imaging of the Spine. Arthritis Rheumatol 2015; 67:924-33. [DOI: 10.1002/art.39001] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 12/11/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Ulrich Weber
- University of Alberta, Edmonton; Alberta Canada
- Balgrist University Hospital; Zurich Switzerland
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Maksymowych WP, Wichuk S, Chiowchanwisawakit P, Lambert RG, Pedersen SJ. Development and preliminary validation of the spondyloarthritis research consortium of Canada magnetic resonance imaging sacroiliac joint structural score. J Rheumatol 2014; 42:79-86. [PMID: 25320219 DOI: 10.3899/jrheum.140519] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE There is an unmet need for reliable assessment of structural progression in the sacroiliac joints (SIJ) of patients with spondyloarthritis (SpA), but radiography is unreliable and lacks responsiveness. We aimed to develop and validate a new scoring method for structural lesions based on magnetic resonance imaging (MRI), the Spondyloarthritis Research Consortium of Canada (SPARCC) SIJ Structural Score (SSS). METHODS The SSS method for assessment of structural lesions is based on T1-weighted spin echo MRI, validated lesion definitions, slice selection according to well-defined anatomical principles, and dichotomous scoring (lesion present/absent) of 5 consecutive slices through the cartilaginous portion of the joint. Scoring ranges are fat metaplasia (0-40), erosion (0-40), backfill (0-20), and ankylosis (0-20). We progressively conducted 3 validation exercises with 2-4 readers on baseline, and either 2-year (exercises 1 and 2) or 1-year (exercise 3) scans from 147 patients with SpA assessed blinded to timepoint. Interobserver reliability was assessed by intraclass correlation coefficient (ICC) and smallest detectable change (SDC). RESULTS Interobserver reliability for status score was good to excellent for ankylosis (ICC 0.79-0.98), consistently good for fat metaplasia (ICC 0.71-0.78), moderate to good for erosion (ICC 0.58-0.62), and fair to good for backfill (ICC 0.35-0.66). Reliability for change scores was moderate to good for all structural lesions despite the relatively small changes in scores, and was highest for fat metaplasia when both ICC and SDC values were compared. CONCLUSION The new SPARCC MRI SSS method can detect structural changes in the SIJ with acceptable reliability over a 1-2-year timeframe, and should be further validated in patients with SpA.
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Affiliation(s)
- Walter P Maksymowych
- From the Department of Medicine; Department of Radiology and Diagnostic Imaging, Spondyloarthritis Research Consortium of Canada (SPARCC) Center, University of Alberta, Edmonton, Alberta, Canada; the Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, University of Copenhagen, Denmark.W.P. Maksymowych, FRCP(C), Professor; S. Wichuk, BSc, Research Associate, Department of Medicine; R.G. Lambert, FRCP(C), Professor, Department of Radiology and Diagnostic Imaging, Spondyloarthritis Research Consortium of Canada Center, University of Alberta; P. Chiowchanwisawakit, MD, Department of Medicine, Siriraj Hospital, Mahidol University; S.J. Pedersen, MD, Rheumatologist, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, University of Copenhagen.
| | - Stephanie Wichuk
- From the Department of Medicine; Department of Radiology and Diagnostic Imaging, Spondyloarthritis Research Consortium of Canada (SPARCC) Center, University of Alberta, Edmonton, Alberta, Canada; the Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, University of Copenhagen, Denmark.W.P. Maksymowych, FRCP(C), Professor; S. Wichuk, BSc, Research Associate, Department of Medicine; R.G. Lambert, FRCP(C), Professor, Department of Radiology and Diagnostic Imaging, Spondyloarthritis Research Consortium of Canada Center, University of Alberta; P. Chiowchanwisawakit, MD, Department of Medicine, Siriraj Hospital, Mahidol University; S.J. Pedersen, MD, Rheumatologist, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, University of Copenhagen
| | - Praveena Chiowchanwisawakit
- From the Department of Medicine; Department of Radiology and Diagnostic Imaging, Spondyloarthritis Research Consortium of Canada (SPARCC) Center, University of Alberta, Edmonton, Alberta, Canada; the Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, University of Copenhagen, Denmark.W.P. Maksymowych, FRCP(C), Professor; S. Wichuk, BSc, Research Associate, Department of Medicine; R.G. Lambert, FRCP(C), Professor, Department of Radiology and Diagnostic Imaging, Spondyloarthritis Research Consortium of Canada Center, University of Alberta; P. Chiowchanwisawakit, MD, Department of Medicine, Siriraj Hospital, Mahidol University; S.J. Pedersen, MD, Rheumatologist, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, University of Copenhagen
| | - Robert G Lambert
- From the Department of Medicine; Department of Radiology and Diagnostic Imaging, Spondyloarthritis Research Consortium of Canada (SPARCC) Center, University of Alberta, Edmonton, Alberta, Canada; the Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, University of Copenhagen, Denmark.W.P. Maksymowych, FRCP(C), Professor; S. Wichuk, BSc, Research Associate, Department of Medicine; R.G. Lambert, FRCP(C), Professor, Department of Radiology and Diagnostic Imaging, Spondyloarthritis Research Consortium of Canada Center, University of Alberta; P. Chiowchanwisawakit, MD, Department of Medicine, Siriraj Hospital, Mahidol University; S.J. Pedersen, MD, Rheumatologist, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, University of Copenhagen
| | - Susanne J Pedersen
- From the Department of Medicine; Department of Radiology and Diagnostic Imaging, Spondyloarthritis Research Consortium of Canada (SPARCC) Center, University of Alberta, Edmonton, Alberta, Canada; the Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, University of Copenhagen, Denmark.W.P. Maksymowych, FRCP(C), Professor; S. Wichuk, BSc, Research Associate, Department of Medicine; R.G. Lambert, FRCP(C), Professor, Department of Radiology and Diagnostic Imaging, Spondyloarthritis Research Consortium of Canada Center, University of Alberta; P. Chiowchanwisawakit, MD, Department of Medicine, Siriraj Hospital, Mahidol University; S.J. Pedersen, MD, Rheumatologist, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, University of Copenhagen
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Maksymowych WP, Wichuk S, Chiowchanwisawakit P, Lambert RG, Pedersen SJ. Fat metaplasia and backfill are key intermediaries in the development of sacroiliac joint ankylosis in patients with ankylosing spondylitis. Arthritis Rheumatol 2014. [PMID: 25047851 DOI: 10.1002/art.38792.[epub ahead of print]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Fat metaplasia in bone marrow on T1-weighted magnetic resonance imaging (MRI) scans may develop after resolution of inflammation in patients with ankylosing spondylitis (AS) and may predict new bone formation in the spine. Similar tissue, termed backfill, may also fill areas of excavated bone in the sacroiliac (SI) joints and may reflect resolution of inflammation and tissue repair at sites of erosions. The purpose of this study was to test our hypothesis that SI joint ankylosis develops following repair of erosions and that tissue characterized by fat metaplasia is a key intermediary step in this pathway. METHODS We used the Spondyloarthritis Research Consortium of Canada (SPARCC) SI structural lesion score (SSS) method to assess fat metaplasia, erosions, backfill, and ankylosis on MRIs of the SI joints in 147 patients with AS monitored for 2 years. Univariate and multivariate regression analyses focused first on identifying significant MRI predictors of new backfill and fat metaplasia. We then assessed the role of backfill and fat metaplasia in the development of new ankylosis. All analyses were adjusted for demographic features, treatment, and baseline and 2-year change in SSS values for parameters of inflammation and MRI structural lesions. RESULTS Resolution of inflammation and reduction of erosions were each independently associated with the development of new backfill and fat metaplasia at 2 years on multivariate analyses. Multivariate regression analysis that included demographic features, baseline and 2-year change in parameters of inflammation and MRI structural lesion showed that reduction in erosions (P = 0.0005) and increase in fat metaplasia (P = 0.002) at 2 years was each independently associated with the development of new ankylosis. CONCLUSION Our data support a disease model whereby ankylosis develops following repair of erosions, and fat metaplasia and backfill are key intermediary steps in this pathway.
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Weber U, Østergaard M, Lambert RGW, Pedersen SJ, Chan SM, Zubler V, Rufibach K, Zhao Z, Maksymowych WP. Candidate lesion-based criteria for defining a positive sacroiliac joint MRI in two cohorts of patients with axial spondyloarthritis. Ann Rheum Dis 2014; 74:1976-82. [DOI: 10.1136/annrheumdis-2014-205408] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 05/25/2014] [Indexed: 01/14/2023]
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Pedersen SJ, Wichuk S, Chiowchanwisawakit P, Lambert RG, Maksymowych WP. Tumor necrosis factor inhibitor therapy but not standard therapy is associated with resolution of erosion in the sacroiliac joints of patients with axial spondyloarthritis. Arthritis Res Ther 2014; 16:R100. [PMID: 24755322 PMCID: PMC4060567 DOI: 10.1186/ar4548] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 03/13/2014] [Indexed: 11/22/2022] Open
Abstract
Introduction Radiography is an unreliable and insensitive tool for the assessment of structural lesions in the sacroiliac joints (SIJ). Magnetic resonance imaging (MRI) detects a wider spectrum of structural lesions but has undergone minimal validation in prospective studies. The Spondyloarthritis Research Consortium of Canada (SPARCC) MRI Sacroiliac Joint (SIJ) Structural Score (SSS) assesses a spectrum of structural lesions (erosion, fat metaplasia, backfill, ankylosis) and its potential to discriminate between therapies requires evaluation. Methods The SSS score assesses five consecutive coronal slices through the cartilaginous portion of the joint on T1-weighted sequences starting from the transitional slice between cartilaginous and ligamentous portions of the joint. Lesions are scored dichotomously (present/absent) in SIJ quadrants (fat metaplasia, erosion) or halves (backfill, ankylosis). Two readers independently scored 147 pairs (baseline, 2 years) of scans from a prospective cohort of patients with SpA who received either standard (n = 69) or tumor necrosis factor alpha (TNFα) inhibitor (n = 78) therapy. Smallest detectable change (SDC) was calculated using analysis of variance (ANOVA), discrimination was assessed using Guyatt’s effect size, and treatment group differences were assessed using t-tests and the Mann–Whitney test. We identified baseline demographic and structural damage variables associated with change in SSS score by univariate analysis and analyzed the effect of treatment by multivariate stepwise regression adjusted for severity of baseline structural damage and demographic variables. Results A significant increase in mean SSS score for fat metaplasia (P = 0.017) and decrease in mean SSS score for erosion (P = 0.017) was noted in anti-TNFα treated patients compared to those on standard therapy. Effect size for this change in SSS fat metaplasia and erosion score was moderate (0.5 and 0.6, respectively). Treatment and baseline SSS score for erosion were independently associated with change in SSS erosion score (β = 1.75, P = 0.003 and β = 0.40, P < 0.0001, respectively). Change in ASDAS (β = −0.46, P = 0.006), SPARCC MRI SIJ inflammation (β = −0.077, P = 0.019), and baseline SSS score for fat metaplasia (β = 0.085, P = 0.034) were independently associated with new fat metaplasia. Conclusion The SPARCC SSS method for assessment of structural lesions has discriminative capacity in demonstrating significantly greater reduction in erosion and new fat metaplasia in patients receiving anti-TNFα therapy.
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Weber U, Zubler V, Zhao Z, Lambert RGW, Chan SM, Pedersen SJ, Østergaard M, Rufibach K, Maksymowych WP. Does spinal MRI add incremental diagnostic value to MRI of the sacroiliac joints alone in patients with non-radiographic axial spondyloarthritis? Ann Rheum Dis 2014; 74:985-92. [DOI: 10.1136/annrheumdis-2013-203887] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Accepted: 12/27/2013] [Indexed: 01/28/2023]
Abstract
ObjectiveTo assess the incremental diagnostic value of spine MRI evaluated separately from and combined with sacroiliac joint (SIJ) MRI in non-radiographic axial spondyloarthritis (nr-axSpA) compared with SIJ MRI alone.MethodsThe study sample comprised two independent cohorts A/B of 130 consecutive patients aged ≤50 years with back pain, newly referred to two university clinics, and 20 healthy controls. Patients were classified according to clinical examination and pelvic radiographs as having nr-axSpA (n=50), ankylosing spondylitis (n=33), or non-specific back pain (n=47). Four readers assessed SIJ and spine MRI separately 6 months apart, and 1–12 months later both scans simultaneously using standardised modules. Readers recorded presence/absence of SpA and their level of confidence in this conclusion on a 0–10 scale (0=definitely not; 10=definite). We analysed differences between SIJ MRI versus spine MRI alone, and SIJ MRI alone versus combined MRI, descriptively by the number/percentage of subjects according to the mean of four readers.ResultsIn cohorts A/B, 15.8%/24.2% of patients with nr-axSpA having a negative SIJ MRI were reclassified as being positive for SpA by global evaluation of combined scans. However, 26.8%/11.4% of non-specific back pain controls and 17.5% of healthy volunteers with a negative SIJ MRI were falsely reclassified as having SpA by combined MRI. Low confidence in a diagnosis of SpA by SIJ MRI increased to high confidence by combined MRI in 6.6%/7.3% of patients with nr-axSpA.ConclusionsCombined spine and SIJ MRI added little incremental value compared with SIJ MRI alone for diagnosing patients with nr-axSpA and enhancing confidence in this diagnosis.
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Poggenborg RP, Bird P, Boonen A, Wiell C, Pedersen SJ, Sørensen IJ, Madsen OR, Slot O, Møller JM, Bøyesen P, Hasselquist M, Østergaard M. Pattern of bone erosion and bone proliferation in psoriatic arthritis hands: a high-resolution computed tomography and radiography follow-up study during adalimumab therapy. Scand J Rheumatol 2013; 43:202-8. [DOI: 10.3109/03009742.2013.835865] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Weber U, Pedersen SJ, Zubler V, Rufibach K, Chan SM, Lambert RGW, Østergaard M, Maksymowych WP. Fat infiltration on magnetic resonance imaging of the sacroiliac joints has limited diagnostic utility in nonradiographic axial spondyloarthritis. J Rheumatol 2013; 41:75-83. [PMID: 24293572 DOI: 10.3899/jrheum.130568] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore whether morphological features of fat infiltration (FI) on sacroiliac joint (SIJ) magnetic resonance imaging (MRI) contribute to diagnostic utility in 2 inception cohorts of patients with nonradiographic axial spondyloarthritis (nr-axSpA). METHODS Four blinded readers assessed SIJ MRI in 2 cohorts (A/B) of 157 consecutive patients with back pain who were ≤ 50 years old, and in 20 healthy controls. Patients were classified according to clinical examination and pelvic radiography as having nr-axSpA (n = 51), ankylosing spondylitis (n = 34), or nonspecific back pain (n = 72). Readers recorded FI, bone marrow edema (BME), and erosion, predefined morphological features of FI (distinct border, homogeneity, subchondral location), and anatomical distribution of SIJ FI. The proportion of SIJ quadrants affected by FI and frequencies of various SIJ FI features were analyzed descriptively. We calculated positive/negative likelihood ratios (LR) to estimate the diagnostic utility of various features of FI, with and without associated BME, and erosion. RESULTS Of the patients with nr-axSpA in cohorts A/B, 45.0%/48.4% had FI in ≥ 2 SIJ quadrants. Of those, 25.0%/22.6% and 20.0%/25.8% showed FI with distinct border or homogeneous pattern, respectively, and 50% to 100% of those patients displayed concomitant BME or erosion. FI per se in ≥ 2 SIJ quadrants had no diagnostic utility (LR+ 1.62/1.91). FI with distinct border (LR+ 8.29/2.13) or homogeneity (LR+ 6.24/3.78) demonstrated small to moderate diagnostic utility. CONCLUSION SIJ FI per se was not of clinical utility in recognition of nr-axSpA. Distinct border or homogeneity of FI on SIJ MRI showed small to moderate diagnostic utility in nr-axSpA, but were strongly associated with concomitant BME or erosion, highlighting the contextual interpretation of SIJ MRI.
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Affiliation(s)
- Ulrich Weber
- From the Department of Rheumatology and the Department of Radiology, Balgrist University Hospital, Zurich, Switzerland; Copenhagen Center for Arthritis Research, Center for Rheumatology and Spinal Diseases, University of Copenhagen, Copenhagen, Denmark; Rufibach rePROstat, Basel, Switzerland; Department of Ophthalmology, the Department of Radiology and Diagnostic Imaging, and the Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Weber U, Zubler V, Pedersen SJ, Rufibach K, Lambert RGW, Chan SM, Østergaard M, Maksymowych WP. Development and Validation of a Magnetic Resonance Imaging Reference Criterion for Defining a Positive Sacroiliac Joint Magnetic Resonance Imaging Finding in Spondyloarthritis. Arthritis Care Res (Hoboken) 2013. [DOI: 10.1002/acr.21893] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Ulrich Weber
- Balgrist University Hospital; Zurich; Switzerland
| | | | | | - Kaspar Rufibach
- Rufibach rePROstat and F. Hoffmann- La Roche; Basel; Switzerland
| | | | | | | | - Walter p. Maksymowych
- University of Alberta and Alberta Innovates Health Solutions; Edmonton; Alberta; Canada
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Pedersen SJ, Weber U, Østergaard M. The diagnostic utility of MRI in spondyloarthritis. Best Pract Res Clin Rheumatol 2012; 26:751-66. [DOI: 10.1016/j.berh.2012.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 10/12/2012] [Indexed: 01/18/2023]
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Weber U, Pedersen SJ, Østergaard M, Rufibach K, Lambert RGW, Maksymowych WP. Can erosions on MRI of the sacroiliac joints be reliably detected in patients with ankylosing spondylitis? - A cross-sectional study. Arthritis Res Ther 2012; 14:R124. [PMID: 22626458 PMCID: PMC3446505 DOI: 10.1186/ar3854] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2011] [Revised: 03/27/2012] [Accepted: 05/24/2012] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Erosions of the sacroiliac joints (SIJ) on pelvic radiographs of patients with ankylosing spondylitis (AS) are an important feature of the modified New York classification criteria. However, radiographic SIJ erosions are often difficult to identify. Recent studies have shown that erosions can be detected also on magnetic resonance imaging (MRI) of the SIJ early in the disease course before they can be seen on radiography. The goals of this study were to assess the reproducibility of erosion and related features, namely, extended erosion (EE) and backfill (BF) of excavated erosion, in the SIJ using a standardized MRI methodology. METHODS Four readers independently assessed T1-weighted and short tau inversion recovery sequence (STIR) images of the SIJ from 30 AS patients and 30 controls (15 patients with non-specific back pain and 15 healthy volunteers) ≤ 45 years old. Erosions, EE, and BF were recorded according to standardized definitions. Reproducibility was assessed by percentage concordance among six possible reader pairs, kappa statistics (erosion as binary variable) and intraclass correlation coefficient (ICC) (erosion as sum score) for all readers jointly. RESULTS SIJ erosions were detected in all AS patients and six controls by ≥ 2 readers. The median number of SIJ quadrants affected by erosion recorded by four readers in 30 AS patients was 8.6 in the iliac and 2.1 in the sacral joint portion (P < 0.0001). For all 60 subjects and for all four readers, the kappa value for erosion was 0.72, 0.73 for EE, and 0.63 for BF. ICC for erosion was 0.79, 0.72 for EE, and 0.55 for BF, respectively. For comparison, the kappa and ICC values for bone marrow edema were 0.61 and 0.93, respectively. CONCLUSIONS Erosions can be detected on MRI to a comparable degree of reliability as bone marrow edema despite the significant heterogeneity of their appearance on MRI.
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Affiliation(s)
- Ulrich Weber
- Department of Medicine, Division of Rheumatology, 562 Heritage Medical Research Building, University of Alberta, Edmonton, Alberta, Canada T6G 2S2.
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