Journal Article

Comparison of MRI with radiography for detecting structural lesions of the sacroiliac joint using CT as standard of reference: results from the SIMACT study

Hamm, Bernd, Schwenke, Carsten, Greese, Juliane, Poddubnyy, Denis, Hermann, Kay-Geert A, Sieper, Joachim, Diekhoff, Torsten

2017

Overview

ObjectiveRadiographs of sacroiliac (SI) joints are used for the detection of structural damage in patients with axial spondyloarthritis (axSpA), but are often difficult to interpret. Here, we address the question how the T1-weighted MRI (T1w MRI) sequence compares with radiography for SI joints’ structural lesions using low-dose CT as the standard of reference.MethodsRadiographs, T1w MRI and low-dose CT of the SI joints from 110 patients (mean age 36.1 (19–57) years, 52% males and 48% females; 53% with axSpA, 21 non-radiographic axSpA and 32% radiographic axSpA, 47% with non-SpA) referred to the rheumatologist because of unclear chronic back pain, but possible axSpA, were scored for structural lesions (erosions, sclerosis, joint space changes and an overall impression of positivity).ResultsUsing low-dose CT as the standard of reference, T1w MRI showed markedly better sensitivity with significantly more correct imaging findings compared with radiography for erosions (79% vs 42%; p=0.002), joint space changes (75% vs 41%; p=0.002) and overall positivity (85% vs 48%; p=0.001), respectively, while there were no differences between X-rays and MRI-T1 sequence regarding specificity (>80% for all scores). Only for sclerosis, MRI-T1 was inferior to radiography (sensitivity 30% vs 70%, respectively), however, not statistically significant (p=0.663).ConclusionsT1w MRI was superior to radiography in the detection of structural lesion of the SI joints in patients with axSpA. Future studies should focus on finding an agreement on the definition of MRI-T1 positivity.

• Publisher: Elsevier Limited
• Subject: Adult / Arthritis / Back pain / Case-Control Studies / Chronic pain / Computed tomography / Cross-Sectional Studies / Female / Humans / Inflammatory diseases / Magnetic Resonance Imaging / Male / Medical imaging / Middle Aged / Prospective Studies / Radiography / Rheumatic diseases / Rheumatology / Sacroiliac Joint - diagnostic imaging / Sacroiliitis - diagnostic imaging / Sclerosis / Sensitivity and Specificity / Spondylarthropathies - diagnostic imaging / Statistical analysis / Studies / Tomography, X-Ray Computed / Young Adult