Imaging of the sacroiliac joints is important for diagnosing early axial spondyloarthritis but not all-decisive

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Ez-Zaitouni, Z. (author)

Imaging of the sacroiliac joints is important for diagnosing early axial spondyloarthritis but not all-decisive

Article/chapterEnglish2018

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2018-03-20
Oxford University Press (OUP),2018

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LIBRIS-ID:oai:gup.ub.gu.se/269382
https://gup.ub.gu.se/publication/269382URI
https://doi.org/10.1093/rheumatology/key035DOI

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Language:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Objectives: To evaluate the contribution of the results of sacroiliac imaging to diagnosis and to the level of confidence in diagnosis in patients presenting with chronic back pain (CBP) and suspected of having axial spondyloarthritis (axSpA). Methods. Data from 513 patients from the SPondyloArthritisCaughtEarly cohort with CBP (>= 3 months, <= 2 years, onset <45 years) were analysed after full diagnostic work-up. Rheumatologists were asked not only to provide a diagnosis before and after the imaging results had been provided to them, but also to provide the level of confidence of this diagnosis on an 11-point numerical scale. Results. Before imaging, 317/513 patients were diagnosed with axSpA. Of these patients, 178/317 (56%) did not have signs of sacroiliitis on either MRI or radiography, which led to the rheumatologist refuting the initial diagnosis of axSpA in 81/178 (46%) patients. Of the 196/513 patients without axSpA before imaging, 35/196 (18%) had signs of sacroiliitis on imaging. Subsequently, 28/35 (80%) patients were diagnosed with axSpA. Overall, imaging was incongruent with the diagnosis before imaging in 213 patients. This led to a change in diagnosis in 109/213 (51%), which corresponds to 21% (109/513) of all patients in the cohort. In general, diagnostic confidence increased by having imaging results available (from 6.2 to 7.4, P<0.001). Conclusion: In patients with CBP suspected of having axSpA, sacroiliac imaging adds to the confidence in the final diagnosis. However, the number of changes in diagnosis suggests that imaging is important but not all-decisive in early axSpA diagnosis.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Reumatologi och inflammation hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Rheumatology and Autoimmunity hsv//eng
axial spondyloarthritis
ankylosing spondylitis
magnetic resonance imaging
clinical diagnosis
early space cohort
classification criteria
ankylosing-spondylitis
management
Rheumatology

Added entries (persons, corporate bodies, meetings, titles ...)

Landewe, R. (author)
van Lunteren, M. (author)
Bakker, P. A. (author)
Fagerli, K. M. (author)
Ramonda, R. (author)
Jacobsson, Lennart T. H.,1954Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research(Swepub:gu)xjacle (author)
van der Heijde, D. (author)
van Gaalen, F. A. (author)
Göteborgs universitetInstitutionen för medicin, avdelningen för reumatologi och inflammationsforskning (creator_code:org_t)

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In:Rheumatology: Oxford University Press (OUP)57:7, s. 1173-11791462-03241462-0332

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