Magnetic resonance imaging assessment in patients with axial spondyloarthritis: development of checklists for use in clinical practice
The objective of our study was to standardize magnetic resonance imaging (MRI) assessment of spine and sacroiliac joints in patients with axial spondyloarthritis (axSpA) and/or inflammatory spinal pain, by creating checklists and templates based on the opinions of rheumatologists and radiologists. A scientific committee developed a series of questionnaires with multiple items regarding MRI in patients with axial inflammatory pain and/or axSpA. Then an expert panel of rheumatologists and radiologists rated all items in a 9-point Likert scale. Finally, the scientific committee and the expert panel met to create the definitive documents. Several definitive checklists and templates were generated for rheumatologist-requested MRI and for radiologist-requested MRI reports of sacroiliac joint and spinal examinations. A technical requirement protocol was also agreed on. Our results could be useful in increasing understanding between rheumatologists and radiologists regarding MRI in axSpA diagnosis and follow-up.
KeywordsAnkylosing spondylitis Magnetic resonance imaging Rheumatologists Radiologists Surveys and questionnaires
The authors did not receive any financial or material support for the study or any technical assistance in writing the manuscript. The authors have no financial relationship that may involve a conflict of interest.
All authors, particularly RA, AB and PZ, contributed to the study conception and design as well as to material preparation, data collection, and analysis. RA, AB, and PZ wrote the first draft of the manuscript; then, all authors commented on previous versions of the manuscript, revising it critically for important intellectual content. All authors read and approved the final manuscript. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work have been appropriately investigated and resolved.
The authors did not receive any financial or material support for the study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Spanish Society of Rheumatology (2017) Espoguía Working Group. Clinical practice guidelines for the management of axial spondyloarthritis and psoriasic arthritis. Update. https://www.ser.es/wp-content/uploads/2016/03/ESPOGUIA-actualización-2017_DEF_web.pdf. Accessed 18 Jun 2019
- 2.López-Medina C, Garrido-Castro JL, Castro-Jiménez J et al (2018) Evaluation of quality of life in patients with axial spondyloarthritis and its association with disease activity, functionality, mobility, and structural damage. Clin Rheumatol 37:1581–1588. https://doi.org/10.1007/s10067-018-4112-4 CrossRefPubMedGoogle Scholar
- 3.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. https://doi.org/10.1136/ard.2009.108233 CrossRefPubMedGoogle Scholar
- 5.Uson J, Loza E, Möller I et al (2018) Recommendations for the use of ultrasound and magnetic resonance in patients with spondyloarthritis, including psoriatic arthritis, and patients with juvenile idiopathic arthritis. Reumatol Clín 14:27–35. https://doi.org/10.1016/j.reuma.2016.08.008 CrossRefPubMedGoogle Scholar
- 10.Schueller-Weidekamm C, Mascarenhas V, Sudol-Szopinska I et al (2014) Imaging and interpretation of axial spondylarthritis: the radiologist’s perspective—consensus of the arthritis subcommittee of the ESSR. Semin Musculoskelet Radiol 18:265–279. https://doi.org/10.1055/s-0034-1375569 CrossRefPubMedGoogle Scholar
- 11.Schueller-Weidekamm C, Mascarenhas V, Sudol-Szopinska I et al (2014) Imaging and interpretation of axial spondylarthritis: the radiologist’s perspective—consensus of the arthritis subcommittee of the ESSR. Semin Musculoskelet Radiol 18:523–524. https://doi.org/10.1055/s-0034-1395421 CrossRefGoogle Scholar
- 17.Sudoł-Szopińska I, Urbanik A, Wojciechowski W et al (2015) Polish Medical Society of Radiology and Polish Society of rheumatology recommendations for magnetic resonance imaging of musculoskeletal disorders in rheumatology. Pol J Radiol 80:259–265. https://doi.org/10.12659/PJR.893670 CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Tant L, Delmotte N, Van den Enden M et al (2017) High prevalence of undiagnosed axial spondyloarthritis in patients with chronic low back pain consulting non-rheumatologist specialists in Belgium: SUSPECT study. Rheumatol Ther 4:121–132. https://doi.org/10.1007/s40744-016-0051-1 CrossRefPubMedPubMedCentralGoogle Scholar
- 31.Ward MM, Deodhar A, Gensler LS et al (2019) 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheumatol. https://doi.org/10.1002/art.41042 CrossRefPubMedGoogle Scholar