Abstract
Purpose
The aim of this study was to compare the value of different imaging techniques in spondyloarthropathy (SpA) patients with inflammatory low back pain.
Patients and methods
We evaluated 54 patients who fulfilled the European spondyloarthropathy classification criteria and had inflammatory low back pain. They were subdivided into two groups according to changes on plain radiography rated on a 0–4 scale according to modified New York criteria. Group A patients had at least grade-2 unilateral or bilateral changes in the sacroiliac (SI) joints, whereas group B included patients with radiologic changes not exceeding grade 0–1. Quantitative SI scintigraphy and magnetic resonance imaging (MRI) were performed to investigate the value of these techniques to the diagnosis of sacroiliitis, and the sacroiliac joint:sacrum uptake ratios were calculated. Scintiscanning was done in 80 healthy subjects to define the normal range.
Results
The sensitivities of plain radiography, quantitative SI scintigraphy, and MRI were 61%, 55%, and 89%, respectively, among the patients with SpA. MRI and quantitative SI scintigraphy detected sacroiliitis in 97% and 49% of group A, respectively. In group B, these results were 76% and 66%, respectively.
Conclusion
Magnetic resonance imaging is the most sensitive method for detecting acute or chronic changes in SpA patients with histories of inflammatory low back pain and normal or indeterminate findings on plain radiographs.
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References
Dougados M, van der Linden S, Juhlin R, Huitfeldt B, Amor B, Calin A, Cats A, Dijkmans B, Olivieri I, Pasero G, Veys E, Zeidler H, European Spondylarthropathy Study Group (1991) The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum 34:1218–1227
Braun J, Bollow M, Sieper J (1998) Radiologic diagnosis and pathology of the spondyloarthropathies. Rheum Dis Clin North Am 24:697–735
Braun J, Sieper J, Bolllow M (2000) Imaging of sacroiliitis. Clin Rheumatol 19:51–57
Khan MA (2002) Thoughts concerning the early diagnosis of ankylosing spondylitis and related diseases. Clin Exp Rheumatol 20 [Suppl 28]:6–10
van der Linden SM, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 27:361–368
Holder LE, Fogelman I, Collier BD (2000) An atlas of planar and SPECT bone scans. Second edn. Dunitz, London
Şen F (2003) Assessment of the effects of age and gender on obtaining normal sacroiliac index values in quantitative bone scintigraphy (thesis). University of Marmara, Istanbul
Docherty P, Mitchell MJ, MacMillan L, Mosher D, Barnes DC, Hanly JG (1992) Magnetic resonance imaging in the detection of sacroiliitis. J Rheumatol 19:393–401
van der Linden SI, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. Arthritis Rheum 27:361–368
Khan MA (2002) Ankylosing spondylitis: introductory comments on its diagnosis and treatment. Ann Rheum Dis 61 [Suppl 3]:3–7
Oostveen J, Prevo R, den Boer J, van de Laar M (1999) Early detection of sacroiliitis on magnetic resonance imaging and subsequent development of sacroiliitis on plain radiography. A prospective, longitudinal study. J Rheumatol 26:1953–1958
Yu W, Feng F, Dion E, Yang H, Jiang M, Genant HK (1994) Comparison of radiography, computed tomography and magnetic resonance imaging in the detection of sacroiliitis accompanying ankylosing spondylitis. Skeletal Radiol 23:289–292
Miron SD, Khan MA, Wiesen EJ, Kushner I, Bellon EM (1983) The value of quantitative sacroiliac scintigraphy in detection of sacroiliitis. Clin Rheumatol 2:407–414
Kacar G, Kacar C, Karayalcin B, Gungor F, Tuncer T, Erkilic M (1998) Quantitative sacroiliac joint scintigraphy in normal subjects and patients with sacroiliitis. Ann Nucl Med 12:169–173
Esdaile JM, Rosenthall L, Terkeltaub R, Kloiber R (1980) Prospective evaluation of sacroiliac scintigraphy in chronic inflammatory back pain. Arthritis Rheum 23:998–1003
Battafarano DF, West SD, Rak KM, Fortenbery EJ, Chantelois AE (1993) Comparison of bone scan, computed tomography and magnetic resonance imaging in the diagnosis of sacroiliitis. Semin Arthritis Rheum 23:161–176
Blum U, Buitrago-Tellez C, Mundinger A, Krause T, Laubenberger J, Vaith P, Peter HH, Langer M (1996) Magnetic resonance imaging (MRI) for detection of active sacroiliitis—a prospective study comparing conventional radiography, scintigraphy and contrast enhanced MRI. J Rheumatol 23:2107–2115
Gran JT, Ostensen M (1998) Spondyloarthritides in females. Baillieres Clin Rheumatol 12:695–715
Hanly JG, Mitchell MJ, Barnes DC, MacMillan L (1994) Early recognition of sacroiliitis by magnetic resonance imaging and single photon emission computed tomography. J Rheumatol 21:2088–2095
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Inanc, N., Atagündüz, P., Şen, F. et al. The investigation of sacroiliitis with different imaging techniques in spondyloarthropathies. Rheumatol Int 25, 591–594 (2005). https://doi.org/10.1007/s00296-004-0490-9
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DOI: https://doi.org/10.1007/s00296-004-0490-9