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Rigshospitalet - a part of Copenhagen University Hospital
E-pub ahead of print

Anatomical distribution of sacroiliac joint MRI lesions in axial spondyloarthritis and control subjects

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OBJECTIVES: To investigate the anatomical location and distribution of MRI lesions in the sacroiliac joints(SIJs) in patients with axial spondyloarthritis(axSpA), women with and without post-partum pain (childbirth within 4-16 months), patients with disc herniation, cleaning staff, runners, and healthy persons.

METHODS: In a prospective cross-sectional study of 204 participants, MRI of the entire cartilaginous compartment of the SIJ was scored blindly by two independent, experienced readers, according to the SPARCC SIJ Inflammation and Structural(SSS) lesion definitions, in each SIJ quadrant/half in each of 9 slices. The location of lesions (unilateral/bilateral, upper/lower, sacral/iliac, anterior/central/posterior slices) were analysed based on concordant reads.

RESULTS: Bone marrow edema (BME) occurred in all quadrants in nearly all participant groups, but rarely bilaterally, except in axSpA and women with post-partum pain. Fat lesions (FAT) were mainly found in axSpA, occurred in all quadrants but mostly bilaterally in sacral quadrants. Erosion was rare, except in axSpA, where it was mainly iliac and often bilateral. Sclerosis was exclusively iliac, and most frequent in women with post-partum pain.

CONCLUSIONS: The location and distribution of common SIJ lesions in axSpA and non-axSpA were reported and group specific patterns were revealed. BME distributed bilaterally or unilaterally, both locally and more widespread in the SIJ, is common in both post-partum women with pain and axSpA patients, limiting the use of BME to differentiate these groups. This study indicates that the presence of FAT, especially when widespread, and/or erosion, particularly when located centrally or posteriorly, are diagnostically important and should be investigated further.

Original languageEnglish
JournalArthritis Care & Research
ISSN2151-464X
DOIs
Publication statusE-pub ahead of print - 2021

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