Format

Send to

Choose Destination
Ann Rheum Dis. 2016 Nov;75(11):1958-1963. doi: 10.1136/annrheumdis-2015-208642. Epub 2016 Jan 14.

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

Author information

1
Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
2
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
3
King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark South Jutland Hospital and Institute of Regional Health Services Research, University of Southern Denmark, Odense, Denmark.
4
Endokrinologikum Berlin and Charité University Medicine, Berlin, Germany.
5
Department of Radiology, Charité Universitätsmedizin, Berlin, Germany.
6
Charité Universitätsmedizin, Berlin, Germany.
7
Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany.
8
Defence Medical Rehabilitation Centre, Surry, UK.
9
Department of Rheumatology, Hospital General de México and Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico.
10
Department of Rheumatology, Hôpital Cochin, Paris Descartes University, Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France.
11
Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
12
Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.
13
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
14
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
15
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
16
Ghent University Hospital, Ghent, Belgium.
17
Department of Rheumatology, VU University Medical Centre, Amsterdam, The Netherlands.
18
Amsterdam Rheumatology & Immunology Center, Academic Medical Center, Amsterdam, The Netherlands.

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:

Ankylosing Spondylitis; Magnetic Resonance Imaging; Spondyloarthritis

PMID:
26768408
DOI:
10.1136/annrheumdis-2015-208642
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center