Clinical Rheumatology

, Volume 32, Issue 10, pp 1511–1517 | Cite as

Baseline sacroiliac joint magnetic resonance imaging abnormalities and male sex predict the development of radiographic sacroiliitis

  • Servet Akar
  • Sibel Isik
  • Bilge Birlik
  • Dilek Solmaz
  • Ismail Sari
  • Fatos Onen
  • Nurullah Akkoc
Original Article


We evaluated the relationship between the baseline sacroiliac joint (SIJ) magnetic resonance imaging (MRI) findings and the development of radiographic sacroiliitis and tested their prognostic significance in cases of ankylosing spondylitis. Patients who had undergone an SIJ MRI at the rheumatology department were identified. Individuals for whom pelvic X-rays were available after at least 1 year of MRI were included in the analysis. All radiographs and MRI examinations were scored by two independent readers. Medical records of the patients were reviewed to obtain potentially relevant demographic and clinical data. We identified 1,069 SIJ MRIs, and 328 fulfilled our inclusion criteria. Reliability analysis revealed moderate to good inter- and intra-observer agreement. On presentation data, 14 cases were excluded because they had unequivocal radiographic sacroiliitis at baseline. After a mean of 34.8 months of follow-up, 24 patients developed radiographic sacroiliitis. The presence of active sacroiliitis (odds ratio (OR) 15.1) and structural lesions on MRI (OR 8.3), male sex (OR 4.7), fulfillment of Calin’s inflammatory back pain criteria (P = 0.001), and total MRI activity score (P < 0.001) were found to be related to the development of radiographic sacroiliitis. By regression modeling, the presence of both active inflammatory and structural damage lesions on MRI and male sex were found to be predictive factors for the development of radiographic sacroiliitis. Our present results suggest that the occurrence of both active inflammatory and structural lesions in SIJs revealed by MRI is a significant risk factor for radiographic sacroiliitis, especially in male patients with early inflammatory back pain.


Ankylosing Magnetic resonance imaging Sacroiliitis Spondylitis 





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Copyright information

© Clinical Rheumatology 2013

Authors and Affiliations

  • Servet Akar
    • 1
  • Sibel Isik
    • 2
  • Bilge Birlik
    • 3
  • Dilek Solmaz
    • 1
  • Ismail Sari
    • 1
  • Fatos Onen
    • 1
  • Nurullah Akkoc
    • 1
  1. 1.Department of Internal Medicine, Division of RheumatologyDokuz Eylul University School of MedicineIzmirTurkey
  2. 2.Department of Internal MedicineDokuz Eylul University School of MedicineIzmirTurkey
  3. 3.Department of RadiologyDokuz Eylul University School of MedicineIzmirTurkey

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