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Association of anatomical variants of the sacroiliac joint with bone marrow edema in patients with axial spondyloarthritis

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Abstract

Objective

To determine the prevalence of sacroiliac joint variants in patients with axial spondyloarthritis (axSpA) using MRI-based synthetic CT images and to evaluate their relationships with the presence of bone marrow edema, as this may potentially complicate diagnosing active sacroiliitis on MRI in patients with suspected axSpA.

Methods

172 patients were retrospectively included. All patients underwent MRI because of clinical suspicion of sacroiliitis. The diagnosis of axSpA was made by a tertiary hospital rheumatologist. Two readers independently determined the presence of bone marrow edema and the presence of one or more of the nine known sacroiliac joint (SIJ) variants.

Results

SIJ variants were common in axSpA patients (82.9%) and the non-SpA group (85.4%); there were no significant differences in prevalence. Bone marrow edema was frequently found in axSpA (86.8%) and non-SpA patients (34%). AxSpA patients with SIJ variants (except for accessory joint) demonstrated 4 to 10 times higher odds for bone marrow edema, however not statistically significant. The more variants were present in this group, the higher the chance of bone marrow edema. However, some multicollinearity cannot be excluded, since bone marrow edema is very frequent in the axSpA group by definition.

Conclusion

SIJ variants are common in axSpA and non-SpA patients. SIJ variants were associated with higher prevalence of bone marrow edema in axSpA patients, potentially due to altered biomechanics, except for accessory joint which may act as a stabilizer.

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Data Availability

The datasets generated and analyzed during the current study are not publicly available because the subjects did not provide written consent for their data to be publicly shared.

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Acknowledgements

We acknowledge the administrative support of Griet Alleman.

Author information

Authors and Affiliations

  1. Department of Radiology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium

    Elke Vereecke, Lennart Jans, Nele Herregods, Frederiek Laloo & Lieve Morbée

  2. Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, China

    Min Chen

  3. Department of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta Hospital, Edmonton, AB, Canada

    Jacob L. Jaremko

  4. Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

    Philippe Carron, Filip Van den Bosch & Dirk Elewaut

  5. Department of Rheumatology, Ghent University Hospital, Ghent, Belgium

    Philippe Carron, Gaëlle Varkas, Manouk de Hooge, Filip Van den Bosch & Dirk Elewaut

  6. Molecular Immunology and Inflammation Unit, VIB-UGent Center for Inflammation Research, Zwijnaarde, Belgium

    Philippe Carron, Gaëlle Varkas, Manouk de Hooge, Filip Van den Bosch & Dirk Elewaut

  7. Department of Rheumatology, Jan Palfijn Hospital, Ghent, Belgium

    Gaëlle Varkas

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  1. Elke Vereecke
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Corresponding author

Correspondence to Elke Vereecke.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This study was approved by the institutional ethics committee. Written informed consent was obtained from all individual participants included in the study.

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Vereecke, E., Jans, L., Herregods, N. et al. Association of anatomical variants of the sacroiliac joint with bone marrow edema in patients with axial spondyloarthritis. Skeletal Radiol 53, 507–514 (2024). https://doi.org/10.1007/s00256-023-04435-z

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