https://doi.org/10.4081/reumatismo.2016.885

Spine and sacroiliac joints on magnetic resonance imaging in patients with early axial spondyloarthritis: prevalence of lesions and association with clinical and disease activity indices from the Italian group of the SPACE study

Vol. 68 No. 2 (2016)
Submitted: 30 March 2016
Accepted: 16 July 2016
Published: 9 September 2016
Axial spondyloarthritis, early onset spondyloarthritis, disease activity, clinimetric indices spine, sacroiliac joints.
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Authors

M. Lorenzin
Rheumatology Unit, Department of Medicine, University of Padova, Italy.
A. Ortolan
Rheumatology Unit, Department of Medicine, University of Padova, Italy.
P. Frallonardo
Rheumatology Unit, Department of Medicine, University of Padova, Italy.
S. Vio
Radiology Unit, University of Padova, Italy.
C. Lacognata
Radiology Unit, University of Padova, Italy.
F. Oliviero
Rheumatology Unit, Department of Medicine, University of Padova, Italy.
L. Punzi
Rheumatology Unit, Department of Medicine, University of Padova, Italy.
R. Ramonda
roberta.ramonda@unipd.it
Rheumatology Unit, Department of Medicine, University of Padova, Italy.
Our aim was to determine the prevalence of spine and sacroiliac joint (SIJ) lesions on magnetic resonance imaging (MRI) in patients with early axial spondyloarthritis (axSpA) and their correlation with disease activity indices. Sixty patients with low back pain (LBP) (≥3 months, ≤2 years, onset ≤45 years), attending the SpA-clinic of the Unità Operativa Complessa Reumatologia of Padova [SpondyloArthritis-Caught-Early (SPACE) study], were studied following a protocol including physical examination, questionnaires, laboratory tests, X-rays and spine and SIJ MRI. Positive spine and SIJ MRI and X-rays images were scored independently by 2 readers using the SPARCC method, modified Stoke ankylosing spondylitis spine score and New York criteria. The axial pain and localization of MRI-lesions were referred to 4 sites: cervical/thoracic/lumbar spine and SIJ. All patients were classified into three groups: patients with signs of radiographic sacroiliitis (r-axSpA), patients without signs of r-axSpA but with signs of sacroiliitis on MRI (nr-axSpA MRI SIJ+), patients without signs of sacroiliitis on MRI and X-rays (nr-axSpA MRI SIJ-). The median age at LBP onset was 29.05±8.38 years; 51.6% of patients showed bone marrow edema (BME) in spine-MRI and 56.7% of patients in SIJ-MRI. Signs of enthesitis were found in 55% of patients in the thoracic district. Of the 55% of patients with BME on spine-MRI, 15% presented presented a negative SIJMRI. There was a significant difference between these cohorts with regard to the prevalence of radiographic sacroiliitis, active sacroiliitis on MRI and SPARCC SIJ score. The site of pain correlated statistically with BME lesions in thoracic and buttock districts. Since positive spine-MRI images were observed in absence of sacroiliitis, we can hypothesize that this finding could have a diagnostic significance in axSpA suspected axSpA.

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M. Lorenzin, Rheumatology Unit, Department of Medicine, University of Padova
Rheumatologist, MD
A. Ortolan, Rheumatology Unit, Department of Medicine, University of Padova
Rheumatologist, MD
P. Frallonardo, Rheumatology Unit, Department of Medicine, University of Padova
Rheumatologist, MD
S. Vio, Radiology Unit, University of Padova
Radiologist, MD
C. Lacognata, Radiology Unit, University of Padova
Radiologist,MD PhD
F. Oliviero, Rheumatology Unit, Department of Medicine, University of Padova
Researcher PhD
L. Punzi, Rheumatology Unit, Department of Medicine, University of Padova
Rheumatologist, MD PhD
R. Ramonda, Rheumatology Unit, Department of Medicine, University of Padova
Rheumatologist, MD PhD

How to Cite

Lorenzin, M., Ortolan, A., Frallonardo, P., Vio, S., Lacognata, C., Oliviero, F., … Ramonda, R. (2016). Spine and sacroiliac joints on magnetic resonance imaging in patients with early axial spondyloarthritis: prevalence of lesions and association with clinical and disease activity indices from the Italian group of the SPACE study. Reumatismo, 68(2), 72–82. https://doi.org/10.4081/reumatismo.2016.885

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