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MRI of the sacroiliac joints in spondyloarthritis : the added value of intra-articular signal changes for a 'positive MRI'

(2018) SKELETAL RADIOLOGY. 47(5). p.683-693
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Abstract
Objective: To determine if intra-articular signal changes at the sacroiliac joint space on MRI have added diagnostic value for spondyloarthritis, when compared to bone marrow edema (BME). Materials and methods: A retrospective study was performed on the MRIs of sacroiliac joints of 363 patients, aged 16-45 years, clinically suspected of sacroiliitis. BME of the sacroiliac joints was correlated to intra-articular sacroiliac joint MR signal changes: high T1 signal, fluid signal, ankylosis and vacuum phenomenon (VP). These MRI findings were correlated with final clinical diagnosis. Sensitivity (SN), specificity (SP), likelihood ratios (LR), predictive values and post-test probabilities were calculated. Results: BME had SN of 68.9%, SP of 74.0% and LR+ of 2.6 for diagnosis of spondyloarthritis. BME in absence of intra-articular signal changes had a lower SN and LR+ for spondyloarthritis (SN = 20.5%, LR+ 1.4). Concomitant BME and high T1 signal (SP = 97.2%, LR + = 10.5), BME and fluid signal (SP = 98.6%, LR + = 10.3) or BME and ankylosis (SP = 100%) had higher SP and LR+ for spondyloarthritis. Concomitant BME and VP had low LR+ for spondyloarthritis (SP = 91%, LR + =0.9). When BME was absent, intra-articular signal changes were less prevalent, but remained highly specific for spondyloarthritis. Conclusion: Our results suggest that both periarticular and intra-articular MR signal of the sacroiliac joint should be examined to determine whether an MRI is 'positive' or 'not positive' for sacroiliitis associated with spondyloarthritis.
Keywords
MRI, Spondyloarthritis, Sacroiliac joint, Sacroiliitis, Ankylosis, ANKYLOSING-SPONDYLITIS, BACK-PAIN, CLASSIFICATION, COHORT, SPACE

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Chicago
Laloo, Frederiek, Nele Herregods, Jacob Jaremko, Koenraad Verstraete, and Lennart Jans. 2018. “MRI of the Sacroiliac Joints in Spondyloarthritis : the Added Value of Intra-articular Signal Changes for a ‘Positive MRI’.” Skeletal Radiology 47 (5): 683–693.
APA
Laloo, F., Herregods, N., Jaremko, J., Verstraete, K., & Jans, L. (2018). MRI of the sacroiliac joints in spondyloarthritis : the added value of intra-articular signal changes for a “positive MRI.” SKELETAL RADIOLOGY, 47(5), 683–693.
Vancouver
1.
Laloo F, Herregods N, Jaremko J, Verstraete K, Jans L. MRI of the sacroiliac joints in spondyloarthritis : the added value of intra-articular signal changes for a “positive MRI.”SKELETAL RADIOLOGY. 2018;47(5):683–93.
MLA
Laloo, Frederiek, Nele Herregods, Jacob Jaremko, et al. “MRI of the Sacroiliac Joints in Spondyloarthritis : the Added Value of Intra-articular Signal Changes for a ‘Positive MRI’.” SKELETAL RADIOLOGY 47.5 (2018): 683–693. Print.
@article{8540314,
  abstract     = {Objective: To determine if intra-articular signal changes at the sacroiliac joint space on MRI have added diagnostic value for spondyloarthritis, when compared to bone marrow edema (BME). 
Materials and methods: A retrospective study was performed on the MRIs of sacroiliac joints of 363 patients, aged 16-45 years, clinically suspected of sacroiliitis. BME of the sacroiliac joints was correlated to intra-articular sacroiliac joint MR signal changes: high T1 signal, fluid signal, ankylosis and vacuum phenomenon (VP). These MRI findings were correlated with final clinical diagnosis. Sensitivity (SN), specificity (SP), likelihood ratios (LR), predictive values and post-test probabilities were calculated. 
Results: BME had SN of 68.9\%, SP of 74.0\% and LR+ of 2.6 for diagnosis of spondyloarthritis. BME in absence of intra-articular signal changes had a lower SN and LR+ for spondyloarthritis (SN = 20.5\%, LR+ 1.4). Concomitant BME and high T1 signal (SP = 97.2\%, LR + = 10.5), BME and fluid signal (SP = 98.6\%, LR + = 10.3) or BME and ankylosis (SP = 100\%) had higher SP and LR+ for spondyloarthritis. Concomitant BME and VP had low LR+ for spondyloarthritis (SP = 91\%, LR + =0.9). When BME was absent, intra-articular signal changes were less prevalent, but remained highly specific for spondyloarthritis. 
Conclusion: Our results suggest that both periarticular and intra-articular MR signal of the sacroiliac joint should be examined to determine whether an MRI is 'positive' or 'not positive' for sacroiliitis associated with spondyloarthritis.},
  author       = {Laloo, Frederiek and Herregods, Nele and Jaremko, Jacob and Verstraete, Koenraad and Jans, Lennart},
  issn         = {0364-2348 },
  journal      = {SKELETAL RADIOLOGY},
  language     = {eng},
  number       = {5},
  pages        = {683--693},
  title        = {MRI of the sacroiliac joints in spondyloarthritis : the added value of intra-articular signal changes for a 'positive MRI'},
  url          = {http://dx.doi.org/10.1007/s00256-017-2830-3},
  volume       = {47},
  year         = {2018},
}

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