Rheumatology Medical News about active sacroiliitis;axial spondyloarthritis;MRI

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Defining active sacroiliitis on Magnetic Resonance Imaging (MRI) for classification of axial spondyloarthritis - a consensual approach by the ASAS/ OMERACT MRI Group
Annals of Rheumatic Diseases, 05/26/09

Rudwaleit M et al. – Study reports the MRI findings relevant for sacroiliitis defined by consensus by a group of rheumatologists and radiologists. These definitions should help in applying correctly the imaging feature ‘active sacroiliitis by MRI’ in the new ASAS classification criteria for axial SpA.

Methods

Study was conducted to:
- identify and describe MRI findings in sacroiliitis, and
- to reach consensus on which MRI findings are essential for the definition of sacroiliitis
10 physicians (2 radiologists and 8 rheumatologists) from the ASAS/ OMERACT MRI working group reviewed and discussed MR images depicting sacroiliitis associated with SpA, and other conditions which may mimic SpA
Descriptions of the pathological findings and technical requirements for the appropriate acquisition were formulated
In a consensual approach MRI findings considered to be essential for sacroiliitis were defined

Results

Active inflammatory lesions such as bone marrow edema (BME)/ osteitis, synovitis, enthesitis and capsulitis associated with SpA can be detected by MRI
Among these, the clear presence of BME/ osteitis was considered essential for defining active sacroiliitis
Structural damage lesions such as sclerosis, erosions, fat deposition, and ankylosis can also be detected by MRI
However, the exact place of structural damage lesions for diagnosis and classification is less clear, particularly if these findings are minor
The ASAS group formally approved these proposals by voting at the annual assembly

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