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How sensitive and specific are MRI features of sacroiliitis for diagnosis of spondyloarthritis in patients with inflammatory back pain?

(2014) JBR-BTR. 97. p.202-205
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Abstract
Objective: To determine the sensitivity and specificity of MRI features of sacroiliitis in spondyloarthritis (SpA). Materials and methods: A retrospective study reviewed MRI of the sacroiliac (SI) joints in 517 patients with inflammatory back pain. Sensitivity, specificity, positive and negative likelihood ratios of active and structural lesions of sacroiliitis with final clinical diagnosis as golden standard was calculated. Results: MRI showed active inflammation in 42% of patients (bone marrow oedema (BMO) (41.5%), capsulitis (3.3%), enthesitis (2.5%)) and structural changes in 48.8% of patients (erosion (25%), fat infiltration (31.6%), sclerosis (32%) and ankylosis (7.6%)). BMO was the MRI feature with the highest sensitivity (65.1%) for diagnosis of SpA. Capsulitis (99%), enthesitis (98.4%), ankylosis (97.4%) and erosion (94.8%) had a high specificity for diagnosis of SPA, whereas BMO (74.3%), sclerosis (75.8%) and fat infiltration (84.0%) were less specific. BMO concomitant with enthesitis, capsulitis or erosions increased the specificity. Concomitant presence of BMO and sclerosis or fat infiltration decreased the specificity. Conclusion: BMO is moderately sensitive and specific for diagnosis of SpA in patients with inflammatory back pain. BMO concomitant with enthesitis, capsulitis, ankylosis or erosion increases the specificity. Concomitant fat infiltration or sclerosis decreases the specificity for diagnosis of SpA. Of all lesions, erosion had by far the highest positive likelihood ratio for diagnosis of SpA.
Keywords
MR, Arthritis, Spine, ANKYLOSING-SPONDYLITIS, CLASSIFICATION, CRITERIA

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Citation

Please use this url to cite or link to this publication:

Chicago
Jans, Lennart, Laurent Coeman, Liesbet Van Praet, PHILIPPE CARRON, Dirk Elewaut, Filip Van den Bosch, Jacob L Jaremko, Wouter Huysse, and Koenraad Verstraete. 2014. “How Sensitive and Specific Are MRI Features of Sacroiliitis for Diagnosis of Spondyloarthritis in Patients with Inflammatory Back Pain?” Jbr-btr 97: 202–205.
APA
Jans, L., Coeman, L., Van Praet, L., CARRON, P., Elewaut, D., Van den Bosch, F., Jaremko, J. L., et al. (2014). How sensitive and specific are MRI features of sacroiliitis for diagnosis of spondyloarthritis in patients with inflammatory back pain? JBR-BTR, 97, 202–205.
Vancouver
1.
Jans L, Coeman L, Van Praet L, CARRON P, Elewaut D, Van den Bosch F, et al. How sensitive and specific are MRI features of sacroiliitis for diagnosis of spondyloarthritis in patients with inflammatory back pain? JBR-BTR. 2014;97:202–5.
MLA
Jans, Lennart, Laurent Coeman, Liesbet Van Praet, et al. “How Sensitive and Specific Are MRI Features of Sacroiliitis for Diagnosis of Spondyloarthritis in Patients with Inflammatory Back Pain?” JBR-BTR 97 (2014): 202–205. Print.
@article{5767032,
  abstract     = {Objective: To determine the sensitivity and specificity of MRI features of sacroiliitis in spondyloarthritis (SpA). 
Materials and methods: A retrospective study reviewed MRI of the sacroiliac (SI) joints in 517 patients with inflammatory back pain. Sensitivity, specificity, positive and negative likelihood ratios of active and structural lesions of sacroiliitis with final clinical diagnosis as golden standard was calculated. 
Results: MRI showed active inflammation in 42\% of patients (bone marrow oedema (BMO) (41.5\%), capsulitis (3.3\%), enthesitis (2.5\%)) and structural changes in 48.8\% of patients (erosion (25\%), fat infiltration (31.6\%), sclerosis (32\%) and ankylosis (7.6\%)). 
BMO was the MRI feature with the highest sensitivity (65.1\%) for diagnosis of SpA. Capsulitis (99\%), enthesitis (98.4\%), ankylosis (97.4\%) and erosion (94.8\%) had a high specificity for diagnosis of SPA, whereas BMO (74.3\%), sclerosis (75.8\%) and fat infiltration (84.0\%) were less specific. BMO concomitant with enthesitis, capsulitis or erosions increased the specificity. Concomitant presence of BMO and sclerosis or fat infiltration decreased the specificity. 
Conclusion: BMO is moderately sensitive and specific for diagnosis of SpA in patients with inflammatory back pain. BMO concomitant with enthesitis, capsulitis, ankylosis or erosion increases the specificity. Concomitant fat infiltration or sclerosis decreases the specificity for diagnosis of SpA. Of all lesions, erosion had by far the highest positive likelihood ratio for diagnosis of SpA.},
  author       = {Jans, Lennart and Coeman, Laurent and Van Praet, Liesbet and CARRON, PHILIPPE and Elewaut, Dirk and Van den Bosch, Filip and Jaremko, Jacob L and Huysse, Wouter and Verstraete, Koenraad},
  issn         = {1780-2393},
  journal      = {JBR-BTR},
  language     = {eng},
  pages        = {202--205},
  title        = {How sensitive and specific are MRI features of sacroiliitis for diagnosis of spondyloarthritis in patients with inflammatory back pain?},
  volume       = {97},
  year         = {2014},
}

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