'MRI-tis' in the early diagnosis of axial SpA: issues and limitations

Nature Reviews. Rheumatology
Leen De RyckeDominique Baeten

Abstract

Sacroiliitis on conventional radiography, a key diagnostic feature of axial spondyloarthritis (SpA), often appears only late in the disease course. With the introduction of potent biologic agents that may also be effective in early disease, diagnostic techniques that can identify SpA early in the disease course would be highly beneficial to patients. MRI has been proposed as a novel diagnostic tool for early axial SpA based on the visualization of active inflammatory lesions in established axial SpA, as well as in pre-radiographic axial SpA. Accordingly, MRI is already widely used in clinical practice and has been included in new classification criteria. However, the specificity and predictive value of MRI lesions for the development of axial SpA remain to be fully defined and validated. Most data come from cross-sectional analyses and have not been validated in prospective studies, and the few available prospective studies were performed in highly selected patient populations and have assessed the value of MRI for the prediction of sacroiliitis rather than axial SpA. Also, some studies have indicated considerable diversity in the pattern and extent of MRI lesions, and suggest that many lesions are not specific for SpA. Prospec...Continue Reading

References

Aug 1, 1985·Arthritis and Rheumatism·A G FamF Y Leung
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Jan 1, 1996·Journal of Computer Assisted Tomography·C WittramR C Bucknall
May 22, 2003·Annals of the Rheumatic Diseases·A van TubergenSj van der Linden

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Citations

Oct 15, 2011·Arthritis Research & Therapy·Piet Geusens, Willem F Lems
May 4, 2017·Annals of the Rheumatic Diseases·David S Pisetsky
Oct 7, 2010·Nature Reviews. Rheumatology·Désirée van der HeijdeJochen Sieper

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