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Defining active sacroiliitis on MRI for classification of axial spondyloarthritis : update by the ASAS MRI working group

(2016) ANNALS OF THE RHEUMATIC DISEASES. 75(11). p.1958-1963
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Abstract
Objectives: To review and update the existing definition of a positive MRI for classification of axial spondyloarthritis (SpA). Methods: The Assessment in SpondyloArthritis International Society (ASAS) MRI working group conducted a consensus exercise to review the definition of a positive MRI for inclusion in the ASAS classification criteria of axial SpA. Existing definitions and new data relevant to the MRI diagnosis and classification of sacroiliitis and spondylitis in axial SpA, published since the ASAS definition first appeared in print in 2009, were reviewed and discussed. The precise wording of the existing definition was examined in detail and the data and a draft proposal were presented to and voted on by the ASAS membership. Results: The clear presence of bone marrow oedema on MRI in subchondral bone is still considered to be the defining observation that determines the presence of active sacroiliitis. Structural damage lesions seen on MRI may contribute to a decision by the observer that inflammatory lesions are genuinely due to SpA but are not required to meet the definition. The existing definition was clarified adding guidelines and images to assist in the application of the definition. Conclusion: The definition of a positive MRI for classification of axial SpA should continue to primarily depend on the imaging features of 'active sacroiliitis' until more data are available regarding MRI features of structural damage in the sacroiliac joint and MRI features in the spine and their utility when used for classification purposes.
Keywords
INFLAMMATORY BACK-PAIN, ANKYLOSING-SPONDYLITIS, SPACE COHORT, DESIR COHORT, JOINTS, GADOLINIUM, SPONDYLARTHRITIS, RADIOLOGISTS, CRITERIA

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Chicago
Lambert, Robert GW, Pauline AC Bakker, Désirée van der Heijde, Ulrich Weber, Martin Rudwaleit, Kay-Geert A Hermann, Joachim Sieper, et al. 2016. “Defining Active Sacroiliitis on MRI for Classification of Axial Spondyloarthritis : Update by the ASAS MRI Working Group.” Annals of the Rheumatic Diseases 75 (11): 1958–1963.
APA
Lambert, R. G., Bakker, P. A., van der Heijde, D., Weber, U., Rudwaleit, M., Hermann, K.-G. A., Sieper, J., et al. (2016). Defining active sacroiliitis on MRI for classification of axial spondyloarthritis : update by the ASAS MRI working group. ANNALS OF THE RHEUMATIC DISEASES, 75(11), 1958–1963.
Vancouver
1.
Lambert RG, Bakker PA, van der Heijde D, Weber U, Rudwaleit M, Hermann K-GA, et al. Defining active sacroiliitis on MRI for classification of axial spondyloarthritis : update by the ASAS MRI working group. ANNALS OF THE RHEUMATIC DISEASES. 2016;75(11):1958–63.
MLA
Lambert, Robert GW, Pauline AC Bakker, Désirée van der Heijde, et al. “Defining Active Sacroiliitis on MRI for Classification of Axial Spondyloarthritis : Update by the ASAS MRI Working Group.” ANNALS OF THE RHEUMATIC DISEASES 75.11 (2016): 1958–1963. Print.
@article{8501058,
  abstract     = {Objectives: To review and update the existing definition of a positive MRI for classification of axial spondyloarthritis (SpA). 
Methods: The Assessment in SpondyloArthritis International Society (ASAS) MRI working group conducted a consensus exercise to review the definition of a positive MRI for inclusion in the ASAS classification criteria of axial SpA. Existing definitions and new data relevant to the MRI diagnosis and classification of sacroiliitis and spondylitis in axial SpA, published since the ASAS definition first appeared in print in 2009, were reviewed and discussed. The precise wording of the existing definition was examined in detail and the data and a draft proposal were presented to and voted on by the ASAS membership. 
Results: The clear presence of bone marrow oedema on MRI in subchondral bone is still considered to be the defining observation that determines the presence of active sacroiliitis. Structural damage lesions seen on MRI may contribute to a decision by the observer that inflammatory lesions are genuinely due to SpA but are not required to meet the definition. The existing definition was clarified adding guidelines and images to assist in the application of the definition. 
Conclusion: The definition of a positive MRI for classification of axial SpA should continue to primarily depend on the imaging features of 'active sacroiliitis' until more data are available regarding MRI features of structural damage in the sacroiliac joint and MRI features in the spine and their utility when used for classification purposes.},
  author       = {Lambert, Robert GW and Bakker, Pauline AC and van der Heijde, D{\'e}sir{\'e}e and Weber, Ulrich and Rudwaleit, Martin and Hermann, Kay-Geert A and Sieper, Joachim and Baraliakos, Xenofon and Bennett, Alex and Braun, J{\"u}rgen and Burgos-Vargas, Rub{\'e}n and Dougados, Maxime and Pedersen, Susanne Juhl and Jurik, Anne Grethe and Maksymowych, Walter P and Marzo-Ortega, Helena and {\O}stergaard, Mikkel and Poddubnyy, Denis and Reijnierse, Monique and Van den Bosch, Filip and van der Horst-Bruinsma, Irene and Landew{\'e}, Robert},
  issn         = {0003-4967},
  journal      = {ANNALS OF THE RHEUMATIC DISEASES},
  keyword      = {INFLAMMATORY BACK-PAIN,ANKYLOSING-SPONDYLITIS,SPACE COHORT,DESIR COHORT,JOINTS,GADOLINIUM,SPONDYLARTHRITIS,RADIOLOGISTS,CRITERIA},
  language     = {eng},
  number       = {11},
  pages        = {1958--1963},
  title        = {Defining active sacroiliitis on MRI for classification of axial spondyloarthritis : update by the ASAS MRI working group},
  url          = {http://dx.doi.org/10.1136/annrheumdis-2015-208642},
  volume       = {75},
  year         = {2016},
}

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