Justification for including MRI as a tool in the diagnosis of axial SpA

Article metrics

Abstract

New classification criteria for axial spondyloarthritis (SpA) have been developed and validated. MRI of the sacroiliac joints is an important feature in these criteria. This is rightfully so, as MRI can identify active lesions in the subchondral bone marrow that are thought to be related to the underlying pathophysiological process at the cartilage–bone junction. Follow-up studies using various imaging techniques, including MRI, in unselected patients with undiagnosed back pain of short symptom duration will provide more information on the differential diagnostic capacity of MRI and its predictive value for long-term outcomes. Even longer-term follow-up (>10 years) is necessary to provide reliable data; however, the validity of MRI in the diagnostic process can only be approximated, as it will never cover the entire gestalt of SpA.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1

    De Rycke, L., Maas, M., Tak, P. P. & Baeten, D. 'MRI-tis' in the early diagnosis of axial SpA: issues and limitations. Nat. Rev. Rheumatol. doi:10.1038/nrrheum.2010.161.

  2. 2

    Rudwaleit, M. et al. The development of Assessment of SpondyloArthritis International Society (ASAS) classification criteria for axial spondyloarthritis (part I): classification of paper patients by expert opinion including uncertainty appraisal. Ann. Rheum. Dis. 68, 770–776 (2009).

  3. 3

    Rudwaleit, M. et al. The development of Assessment of SpondyloArthritis International Society (ASAS) classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann. Rheum. Dis. 68, 777–783 (2009).

  4. 4

    Mau, W. et al. Evaluation of early diagnostic criteria for ankylosing spondylitis in a 10 year follow-up. Z. Rheumatol. 49, 82–87 (1990).

  5. 5

    Rudwaleit, M., Khan, M. A. & Sieper, J. The challenge of diagnosis and classification in early ankylosing spondylitis: do we need new criteria? Arthritis Rheum. 52, 1000–1008 (2005).

  6. 6

    Maksymowych, W. P. Ankylosing spondylitis—at the interface of bone and cartilage. J. Rheumatol. 27, 2295–2301 (2000).

  7. 7

    Rudwaleit, M. et al. Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group. Ann. Rheum. Dis. 68, 1520–1527 (2009).

  8. 8

    van Tubergen, A. et al. Radiographic assessment of sacroiliitis by radiologists and rheumatologists: does training improve quality? Ann. Rheum. Dis. 62, 519–525 (2003).

Download references

Author information

D. van der Heijde and M. Rudwaleit researched data for the article. All authors made substantial contributions to discussion of content. D. van der Heijde wrote the article. All authors were involved in review/editing of the manuscript before submission.

Correspondence to Désirée van der Heijde.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and Permissions

About this article

Further reading