Skip to main content
SpringerLink
Log in

Correlation between clinical and MRI disease activity scores in axial spondyloarthritis

  • Brief Report
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Magnetic resonance (MR) imaging-based disease activity scores (DAS) in axial spondyloarthritis (axSpA) are rarely employed in the normal clinical setting, whereas clinical DAS are used routinely to monitor disease activity and set thresholds for biologic treatment. The objectives of this study were to evaluate the correlation between MR and clinical DAS in a general axSpA outpatient population and to assess the difference in MR DAS in individuals with high and low clinical DAS. This was a prospective, cross-sectional observational study. Forty participants with axSpA who presented for MR of the whole spine and sacroiliac joints as part of ongoing management were included. Completion of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score (ASDAS) was performed at the time of MR examination. MR images were scored by two independent observers using the Spondyloarthritis Research Consortium of Canada (SPARCC) MR DAS. There were weak, non-significant correlations between total SPARCC score and BASDAI (r = 0.18, p = 0.26), ASDAS using erythrocyte sedimentation rate (ASDAS-ESR) (r = 0.31, p = 0.07) and ASDAS using C-reactive protein level (ASDAS-CRP) (r = 0.31, p = 0.05). There was no significant difference in the SPARCC score of participants with high and low clinical DAS. MR DAS may provide information about disease activity not provided by the current standard of clinical DAS and may be considered as a useful adjunct in clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Braun J, Baraliakos X (2011) Imaging of axial spondyloarthritis including ankylosing spondylitis. Ann Rheum Dis 70:i97–i103. doi:10.1136/ard.2010.140541

    Article  PubMed  Google Scholar 

  2. Maksymowych WP, Inman RD, Salonen D et al (2005) Spondyloarthritis research consortium of Canada magnetic resonance imaging index for assessment of spinal inflammation in ankylosing spondylitis. Arthritis Rheum 53:502–509. doi:10.1002/art.21337

    Article  PubMed  Google Scholar 

  3. Braun J, Baraliakos X, Golder W et al (2003) Magnetic resonance imaging examinations of the spine in patients with ankylosing spondylitis, before and after successful therapy with infliximab: evaluation of a new scoring system. Arthritis Rheum 48:1126–1136. doi:10.1002/art.10883

    Article  CAS  PubMed  Google Scholar 

  4. Rudwaleit M, Schwarzlose S, Listing J (2004) Is there a place for magnetic resonance imaging (MRI) in predicting a major clinical response (BASDAI 50 %) to TNF alpha blockers in ankylosing spondylitis? [abstract]. Arthritis Rheum 50:S211

    Google Scholar 

  5. Lukas C, Braun J, van der Heijde D et al (2007) Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment. J Rheumatol 34:862–870

    PubMed  Google Scholar 

  6. Van der Heijde D, Landewé R, Hermann K-G et al (2007) Is there a preferred method for scoring activity of the spine by magnetic resonance imaging in ankylosing spondylitis? J Rheumatol 34:871–873

    PubMed  Google Scholar 

  7. Garrett S, Jenkinson T, Kennedy LG et al (1994) A new approach to defining disease status in ankylosing spondylitis: the bath ankylosing spondylitis disease activity index. J Rheumatol 21:2286–2291

    CAS  PubMed  Google Scholar 

  8. Van der Heijde D, Lie E, Kvien TK et al (2008) ASDAS, a highly discriminatory ASAS-endorsed disease activity score in patients with ankylosing spondylitis. Ann Rheum Dis 68:1811–1818. doi:10.1136/ard.2008.100826

    Article  PubMed  Google Scholar 

  9. National Institute for Health and Clinical Excellence (2008) NICE TA 143: Adalimumab, etanercept and infliximab for ankylosing spondylitis

  10. Van der Heijde D, Sieper J, Maksymowych WP et al (2011) 2010 update of the international ASAS recommendations for the use of anti-TNF agents in patients with axial spondyloarthritis. Ann Rheum Dis 70:905–908. doi:10.1136/ard.2011.151563

    Article  PubMed  Google Scholar 

  11. Rudwaleit M, Schwarzlose S, Hilgert ES et al (2007) MRI in predicting a major clinical response to anti-tumour necrosis factor treatment in ankylosing spondylitis. Ann Rheum Dis 67:1276–1281. doi:10.1136/ard.2007.073098

    Article  PubMed  Google Scholar 

  12. Machado P, Landewé RBM, Braun J et al (2012) MRI inflammation and its relation with measures of clinical disease activity and different treatment responses in patients with ankylosing spondylitis treated with a tumour necrosis factor inhibitor. Ann Rheum Dis 71:2002–2005. doi:10.1136/annrheumdis-2012-201999

    Article  PubMed  Google Scholar 

  13. Bredella MA, Steinbach LS, Morgan S et al (2006) MRI of the sacroiliac joints in patients with moderate to severe ankylosing spondylitis. Am J Roentgenol 187:1420–1426. doi:10.2214/AJR.05.1423

    Article  Google Scholar 

  14. Goh L, Suresh P, Gafoor A et al (2007) Disease activity in longstanding ankylosing spondylitis—a correlation of clinical and magnetic resonance imaging findings. Clin Rheumatol 27:449–455. doi:10.1007/s10067-007-0726-7

    Article  PubMed  Google Scholar 

  15. Kiltz U, Baraliakos X, Karakostas P et al (2012) The degree of spinal inflammation is similar in patients with axial spondyloarthritis who report high or low levels of disease activity: a cohort study. Ann Rheum Dis 71:1207–1211. doi:10.1136/annrheumdis-2011-200508

    Article  CAS  PubMed  Google Scholar 

  16. Rudwaleit M, van der Heijde D, Landewé R et al (2009) The development of Assessment of Spondyloarthritis International Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 68:777–783. doi:10.1136/ard.2009.108233

    Article  CAS  PubMed  Google Scholar 

  17. LandewÉ RB, Hermann K-GA, van der Heijde DM et al (2005) Scoring sacroiliac joints by magnetic resonance imaging. A multiple-reader reliability experiment. J Rheumatol 32:2050–2055

    PubMed  Google Scholar 

  18. Machado P, Landewe R, Lie E et al (2011) Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores. Ann Rheum Dis 70:47–53. doi:10.1136/ard.2010.138594

    Article  PubMed  Google Scholar 

  19. Rudwaleit M, Jurik AG, Hermann K-GA et al (2009) 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. doi:10.1136/ard.2009.110767

    Article  CAS  PubMed  Google Scholar 

  20. Hermann K-GA, Baraliakos X, van der Heijde DMFM et al (2012) Descriptions of spinal MRI lesions and definition of a positive MRI of the spine in axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI study group. Ann Rheum Dis 71:1278–1288. doi:10.1136/ard.2011.150680

    Article  PubMed  Google Scholar 

  21. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  CAS  PubMed  Google Scholar 

  22. Boonen A, vander Cruyssen B, de Vlam K et al (2009) Spinal radiographic changes in ankylosing spondylitis: association with clinical characteristics and functional outcome. J Rheumatol 36:1249–1255. doi:10.3899/jrheum.080831

    Article  PubMed  Google Scholar 

  23. Maksymowych WP (2012) MRI and X-ray in axial spondyloarthritis: the relationship between inflammatory and structural changes. Arthritis Res Ther 14:207. doi:10.1186/ar3786

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Disclosure

None.

Author information

Authors and Affiliations

  1. Department of Radiology, Norfolk & Norwich University Hospital, Norwich, UK

    James W. MacKay & Sharief Aboelmagd

  2. Department of Rheumatology, Norfolk & Norwich University Hospital, Norwich, UK

    J. Karl Gaffney

Authors
  1. James W. MacKay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sharief Aboelmagd
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Karl Gaffney
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James W. MacKay.

Additional information

The study received no funding. All the authors contributed to and read the final version of this submission.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

MacKay, J.W., Aboelmagd, S. & Gaffney, J.K. Correlation between clinical and MRI disease activity scores in axial spondyloarthritis. Clin Rheumatol 34, 1633–1638 (2015). https://doi.org/10.1007/s10067-015-2936-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-015-2936-8

Keywords

Search

Navigation