scholarly journals Response to: ‘Correspondence on ‘Which factors are associated with bone marrow oedema suspicious of axial spondyloarthritis as detected by MRI in the sacroiliac joints and the spine in the general population?’ by Su et al

2021 ◽  
pp. annrheumdis-2021-220632
Author(s):  
Xenofon Baraliakos ◽  
Adrian Richter ◽  
Carsten O Schmidt ◽  
Juergen Braun
Keyword(s):  
Bone Marrow ◽  
General Population ◽  
Axial Spondyloarthritis ◽  
Bone Marrow Oedema ◽  
Sacroiliac Joints

scholarly journals Which factors are associated with bone marrow oedema suspicious of axial spondyloarthritis as detected by MRI in the sacroiliac joints and the spine in the general population?

2020 ◽  
pp. annrheumdis-2020-218669
Author(s):  
Xenofon Baraliakos ◽  
Adrian Richter ◽  
Daniel Feldmann ◽  
Anne Ott ◽  
Robin Buelow ◽  
...  
Keyword(s):  
Bone Marrow ◽  
General Population ◽  
Record Linkage ◽  
Negative Binomial ◽  
Axial Spondyloarthritis ◽  
Population Based ◽  
Bone Marrow Oedema ◽  
Hla B27 ◽  
Sacroiliac Joints ◽  
Cross Sectional

ObjectiveIdentify factors associated with presence and extension of spinal and sacroiliac joints (SIJ)–MRI lesions suggestive of axial spondyloarthritis (axSpA) in a population-based cohort (Study of Health in Pomerania) aged <45 years.MethodsSpinal (sagittal T1/T2) and SIJ (semicoronal STIR sequences) MRIs were evaluated by two trained blinded readers. The presence (yes/no) and extension (Berlin MRI Score) of bone marrow oedema (BME) were captured. Degenerative spinal lesions were excluded and discrepancies resolved by consensus. Cross-sectional associations between clinical factors and presence/extension of BME were analysed by logistic/negative binomial regression. Record linkage of claims data was applied to identify participants with axSpA.ResultsMRIs of 793 volunteers were evaluated. The presence of SIJ–BME (odds ratio) was strongly associated delivery during the last year (4.47, 1.49–13.41). For SIJ–BME extension, associations (incidence rate ratios, 95% CI) were found for delivery ((during last year) 4.52, 1.48–13.84), human leucocyte antigen (HLA)-B27+ (2.32, 1.30–4.14), body mass index (25–30 vs <25 kg/m²; 1.86 (1.19–2.89)) and back pain ((last 3 months) 1.55, 1.04–2.31), while for spinal BME, associations were found for age per decade (1.46, 1.13–1.90) and physically demanding work (1.46, 1.06–2.00). Record linkage was available for 694 (87.5%) participants and 9/694 (1.3%) had a record of axSpA (ICD M45.09).ConclusionThese population-based data support the hypothesis of mechanic strain contributing to BME in the general population aged <45 years and the role of HLA-B27+ as a severity rather than a susceptibility factor for SIJ–BME.

scholarly journals Method for Diagnosing the Bone Marrow Edema of Sacroiliac Joint in Patients with Axial Spondyloarthritis Using Magnetic Resonance Image Analysis Based on Deep Learning

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1156
Author(s):  
Kang Hee Lee ◽  
Sang Tae Choi ◽  
Guen Young Lee ◽  
You Jung Ha ◽  
Sang-Il Choi
Keyword(s):  
Bone Marrow ◽  
Deep Learning ◽  
Bone Marrow Edema ◽  
Axial Spondyloarthritis ◽  
Mr Images ◽  
Sacroiliac Joints ◽  
Learning Network ◽  
Active Sacroiliitis ◽  
Deep Learning Network ◽  
Marrow Edema

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease of the sacroiliac joints. In this study, we develop a method for detecting bone marrow edema by magnetic resonance (MR) imaging of the sacroiliac joints and a deep-learning network. A total of 815 MR images of the sacroiliac joints were obtained from 60 patients diagnosed with axSpA and 19 healthy subjects. Gadolinium-enhanced fat-suppressed T1-weighted oblique coronal images were used for deep learning. Active sacroiliitis was defined as bone marrow edema, and the following processes were performed: setting the region of interest (ROI) and normalizing it to a size suitable for input to a deep-learning network, determining bone marrow edema using a convolutional-neural-network-based deep-learning network for individual MR images, and determining sacroiliac arthritis in subject examinations based on the classification results of individual MR images. About 70% of the patients and normal subjects were randomly selected for the training dataset, and the remaining 30% formed the test dataset. This process was repeated five times to calculate the average classification rate of the five-fold sets. The gradient-weighted class activation mapping method was used to validate the classification results. In the performance analysis of the ResNet18-based classification network for individual MR images, use of the ROI showed excellent detection performance of bone marrow edema with 93.55 ± 2.19% accuracy, 92.87 ± 1.27% recall, and 94.69 ± 3.03% precision. The overall performance was additionally improved using a median filter to reflect the context information. Finally, active sacroiliitis was diagnosed in individual subjects with 96.06 ± 2.83% accuracy, 100% recall, and 94.84 ± 3.73% precision. This is a pilot study to diagnose bone marrow edema by deep learning based on MR images, and the results suggest that MR analysis using deep learning can be a useful complementary means for clinicians to diagnose bone marrow edema.

scholarly journals THU0492 MAGNETIC RESONANCE IMAGING OF THE SACROILIAC JOINTS IN PATIENTS WITH HYPERMOBILITY: A RETROSPECTIVE COHORT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 482.4-483
Author(s):  
A. Jones ◽  
C. Ciurtin ◽  
H. Kazkaz ◽  
M. Hall-Craggs
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Back Pain ◽  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Bone Marrow Oedema ◽  
Resonance Imaging ◽  
Sacroiliac Joints ◽  
Fatty Change ◽  
Subchondral Sclerosis

Background:The incidence of inflammatory and structural lesions on magnetic resonance imaging of sacroiliac joints (MRI SIJs) in patients with hypermobility related disorders has not been fully investigated. Hypermobile patients are more susceptible to pelvic instability and biomechanical stress of the SIJs, leading to MRI SIJ changes similar to those occurring in spondyloarthritis (SpA). Patients with hypermobility and suspected SpA pose a unique challenge owing to the high prevalence of back pain in the hypermobility cohort and the absence of spinal restriction on clinical examination.Objectives:In this study, we aim to investigate the incidence of MRI SIJ lesions in patients with hypermobility.Methods:We performed a retrospective study of all patients with a confirmed diagnosis of hypermobility related disorders (including hypermobility syndrome, hypermobility spectrum disorders and Ehlers-Danlos Syndromes) referred for an MRI lumbar spine and SIJ between 2011 and 2019 to investigate long-standing back pain. MRIs were examined by a musculoskeletal (MSK) radiologist with more than 25 years of experience, who was blinded to the clinical outcome of the patients. MRI SIJs were assessed for the presence of bone marrow oedema, subchondral sclerosis, erosion, fatty change, enthesitis, ankylosis, joint fluid and capsulitis.Results:51 patients with confirmed hypermobility related disorders were referred for MRI SIJ and lumbar spine between 2011 and 2019. 3 patients demonstrated clinical features in keeping with a diagnosis of SpA and were excluded from the study. 15/48 (31.3%) of patients with hypermobility and back pain (but no clinical picture of SpA) were found to have inflammatory and/or structural lesions on MRI SIJ. The most frequent lesions were small foci of bone marrow oedema (16.6%) followed by subchondral sclerosis (12.5%) and fatty change (10.4%). The incidence of erosions was 4.2%.Conclusion:There is a relatively high incidence of inflammatory and structural lesions on MRI SIJ of patients with hypermobility. The presence of hypermobility should be taken into consideration when interpreting MRI changes in patients with suspected SpA. Further research into long-term outcomes of MRI SIJs in patients with hypermobility and back pain is required to establish the clinical significance of these findings.Disclosure of Interests: :Alexis Jones: None declared, Coziana Ciurtin Grant/research support from: Pfizer, Consultant of: Roche, Modern Biosciences, Hanadi Kazkaz: None declared, Margaret Hall-Craggs: None declared

Is active sacroiliitis on MRI associated with radiographic damage in axial spondyloarthritis? Real-life data from the ASAS and DESIR cohorts

Rheumatology ◽  
2018 ◽  
Vol 58 (5) ◽  
pp. 798-802 ◽  
Author(s):  
Alexandre Sepriano ◽  
Sofia Ramiro ◽  
Robert Landewé ◽  
Maxime Dougados ◽  
Désirée van der Heijde ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Odds Ratio ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Multivariable Analysis ◽  
Real Life ◽  
Daily Practice ◽  
Bone Marrow Oedema ◽  
Number Of Patients ◽  
Structural Progression

Abstract Objective To assess any association between bone marrow oedema on MRI of the sacroiliac joints (MRI-SIJ) according to local readings in daily practice and the development of structural damage on radiographs of the SIJ (X-SIJ) in axial spondyloarthritis (axSpA). Methods Patients with axSpA from the Assessment of the SpondyloArthritis international Society (ASAS) and DEvenir des Spondylarthopathies Indifférenciées Récentes (DESIR) multicentre cohorts were included. MRI-SIJ and X-SIJ were obtained at baseline, and X-SIJ at follow-up after a mean 4.6 years (ASAS) and 5.1 years (DESIR). All images were scored by local readers. Structural damage in the X-SIJ was defined according to the modified New York criteria. The percentage of structural net progression (number of ‘progressors’ minus the number of ‘regressors’ divided by the total number of patients) was assessed and the effect of bone marrow oedema on MRI-SIJ on X-SIJ damage evaluated by multivariable logistic regression. Results In total, 125 (ASAS-cohort) and 415 (DESIR-cohort) patients had baseline MRI-SIJ and complete X-SIJ data available. According to local readings, progression and ‘improvement’ in X-SIJ was seen in both the ASAS- and DESIR-cohort, yielding a net progression that was higher in the former than in the latter (19.2% and 6.3%). In multivariable analysis, baseline bone marrow oedema on MRI-SIJ was strongly associated with X-SIJ structural progression in both ASAS (odds ratio = 3.2 [95% CI: 1.3; 7.9]), and DESIR (odds ratio = 7.6 [95% CI: 4.3; 13.2]). Conclusion Inflammation on MRI-SIJ is associated with future radiographic progression according to local readings despite an expected increased imprecision invoked by local readings.

MRI assessment of bone marrow oedema in the sacroiliac joints of patients with spondyloarthritis: is the SPAIR T2w technique comparable to STIR?

2017 ◽  
Vol 27 (9) ◽  
pp. 3669-3676 ◽  
Author(s):  
Vitor Faeda Dalto ◽  
Rodrigo Luppino Assad ◽  
Michel Daoud Crema ◽  
Paulo Louzada-Junior ◽  
Marcello Henrique Nogueira-Barbosa
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Oedema ◽  
Sacroiliac Joints

Imaging: sacroiliac joints

2016 ◽  
Author(s):  
Walter P. Maksymowych ◽  
Robert G.W. Lambert
Keyword(s):  
Bone Marrow ◽  
Axial Spondyloarthritis ◽  
Clinical Suspicion ◽  
Sacroiliac Joints ◽  
Early Disease ◽  
Radiographic Findings ◽  
Simultaneous Evaluation ◽  
Therapeutic Evaluation ◽  
Mri Evaluation ◽  
Short Tau Inversion Recovery

Radiography of the sacroiliac (SI) joints still forms the cornerstone of diagnosis of axial spondyloarthritis (axSpA), although its limitations in early disease preclude early diagnosis. Equivocal radiographic findings of sacroiliitis should be followed by MRI evaluation of the SI joints, especially if clinical suspicion of SpA is high. Routine diagnostic evaluation for SpA by MRI of the SI joints should include simultaneous evaluation of T1-weighted (T1W) and short tau inversion recovery (STIR) or T2 fat-suppressed scans. Bone marrow oedema (BME) in subchondral bone is the primary MRI feature that points to the diagnosis of SpA, although structural lesions such as erosion and fat metaplasia may also be evident in early disease and enhance confidence in the diagnosis. Both inflammatory and structural lesions in the SI joints on MRI can now be quantified in a reliable manner to facilitate therapeutic evaluation in clinical trials and for basic and clinical research.

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