Magnetic resonance imaging of the sacroiliac joints in SpA: with or without intravenous contrast media? A preliminary report

2019 ◽  
Vol 124 (11) ◽  
pp. 1142-1150 ◽  
Author(s):  
Francesco Gentili ◽  
Luca Cantarini ◽  
Marta Fabbroni ◽  
Aandrea Nigri ◽  
Francesco Giuseppe Mazzei ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Contrast Media ◽  
Preliminary Report ◽  
Resonance Imaging ◽  
Sacroiliac Joints ◽  
Intravenous Contrast ◽  
Intravenous Contrast Media

scholarly journals THU0492 MAGNETIC RESONANCE IMAGING OF THE SACROILIAC JOINTS IN PATIENTS WITH HYPERMOBILITY: A RETROSPECTIVE COHORT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 482.4-483
Author(s):  
A. Jones ◽  
C. Ciurtin ◽  
H. Kazkaz ◽  
M. Hall-Craggs
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Back Pain ◽  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Bone Marrow Oedema ◽  
Resonance Imaging ◽  
Sacroiliac Joints ◽  
Fatty Change ◽  
Subchondral Sclerosis

Background:The incidence of inflammatory and structural lesions on magnetic resonance imaging of sacroiliac joints (MRI SIJs) in patients with hypermobility related disorders has not been fully investigated. Hypermobile patients are more susceptible to pelvic instability and biomechanical stress of the SIJs, leading to MRI SIJ changes similar to those occurring in spondyloarthritis (SpA). Patients with hypermobility and suspected SpA pose a unique challenge owing to the high prevalence of back pain in the hypermobility cohort and the absence of spinal restriction on clinical examination.Objectives:In this study, we aim to investigate the incidence of MRI SIJ lesions in patients with hypermobility.Methods:We performed a retrospective study of all patients with a confirmed diagnosis of hypermobility related disorders (including hypermobility syndrome, hypermobility spectrum disorders and Ehlers-Danlos Syndromes) referred for an MRI lumbar spine and SIJ between 2011 and 2019 to investigate long-standing back pain. MRIs were examined by a musculoskeletal (MSK) radiologist with more than 25 years of experience, who was blinded to the clinical outcome of the patients. MRI SIJs were assessed for the presence of bone marrow oedema, subchondral sclerosis, erosion, fatty change, enthesitis, ankylosis, joint fluid and capsulitis.Results:51 patients with confirmed hypermobility related disorders were referred for MRI SIJ and lumbar spine between 2011 and 2019. 3 patients demonstrated clinical features in keeping with a diagnosis of SpA and were excluded from the study. 15/48 (31.3%) of patients with hypermobility and back pain (but no clinical picture of SpA) were found to have inflammatory and/or structural lesions on MRI SIJ. The most frequent lesions were small foci of bone marrow oedema (16.6%) followed by subchondral sclerosis (12.5%) and fatty change (10.4%). The incidence of erosions was 4.2%.Conclusion:There is a relatively high incidence of inflammatory and structural lesions on MRI SIJ of patients with hypermobility. The presence of hypermobility should be taken into consideration when interpreting MRI changes in patients with suspected SpA. Further research into long-term outcomes of MRI SIJs in patients with hypermobility and back pain is required to establish the clinical significance of these findings.Disclosure of Interests: :Alexis Jones: None declared, Coziana Ciurtin Grant/research support from: Pfizer, Consultant of: Roche, Modern Biosciences, Hanadi Kazkaz: None declared, Margaret Hall-Craggs: None declared

AB1100 PERFORMANCE OF MAGNETIC RESONANCE IMAGING FOR DETECTING SACROILIITIS IN EARLY STAGES OF SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1839.1-1839
Author(s):  
F. Ladeb ◽  
D. Ben Nessib ◽  
M. Bouaziz ◽  
W. Hamdi ◽  
E. Labbene ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Bone Marrow Edema ◽  
Resonance Imaging ◽  
Sacroiliac Joints ◽  
Early Stages ◽  
The Mean ◽  
Marrow Edema

Background:In view of the limited accuracy of clinical evaluation to recognize sacroiliitis, several imaging techniques such as conventional radiographs, scintigraphy, ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) have been used to examine the sacroiliac joints (SIJ).Objectives:The aim of this study was to assess the performance of MRI for detecting sacroiliitis in early stages of spondyloarthritis (SpA).Methods:This cross-sectional prospective monocentric double-blind study included 57 patients consulting for symptoms suggestive of SpA during more than 3 months between February 2014 and February 2017. Patients with conventional radiograph showing a confirmed sacroiliitis (grade 3 or 4) were not included. After clinical examination and blood sampling, eligible patients underwent MRI of SIJ. MR images were interpreted by 2 experimented musculoskeletal radiologists blinded to clinical and laboratory data. Two professors in rheumatology blinded to radiologists’ conclusions, analyzed clinical data, laboratory tests, HLA typing, X-rays and MRI images and divided the patients into 2 groups: confirmed non radiographic SpA (nr-SpA) or no SpA. This classification was considered as the gold standard when analyzing the results.Results:Fifteen men and 42 women were enrolled. The mean age at inclusion was 39.75 ± 11 years [17-59]. The mean duration from the first symptom was 47 ± 39 months [6.6-180]. Forty-three patients were assessed as nr-SpA (75.4%) and 14 patients as no SpA (24.6%). Thirty-three percent of patients were HLA B27 positive. Totally 22 patients had sacroiliitis at MRI, all of them classified as confirmed nr-SpA. Among the nr-SpA group, MRI showed bone marrow edema (BME) in 34.9% of patients and erosions in 44.2% of patients. Among the patients in whom the diagnosis of SpA was excluded, MRI showed bone marrow edema (BME) in 7% of patients and erosions in 7% of patients. A statistically significant association was observed between the presence of sacroiliitis at MRI and rheumatologists’ diagnosis of SpA (p=0.001). The diagnostic value of MRI lesions is presented in the following table:Sensitivity (%)Specificity (%)Positive Predictive Value (%)Positive Predictive Value (%)BME34.992.993.731.7Erosions44.292.99535.1MRI conclusion: sacroiliitis51.210010040Conclusion:SIJ MRI had an excellent specificity for the diagnosis of SpA but a moderate sensitivity. Consequently, some patients in early stages of SpA might be missed by MRI. In addition, we found that diagnostic based solely on BME lacked sensitivity. Detection of erosions in addition to BME enhanced sensitivity (from 34.9% to 44.9%) without changing specificity. Indeed, many recent studies have pointed out the importance of considering structural lesions of SIJ in addition to inflammatory lesions [1, 2].References:[1]Weber U, Lambert RGW, Pedersen SJ, et al (2010) Assessment of structural lesions in sacroiliac joints enhances diagnostic utility of magnetic resonance imaging in early spondylarthritis. Arthritis Care Res 62:1763–1771.https://doi.org/10.1002/acr.20312[2]Weber U, Jurik AG, Lambert RGW, Maksymowych WP (2016) Imaging in Spondyloarthritis: Controversies in Recognition of Early Disease. Curr Rheumatol Rep 18:58.https://doi.org/10.1007/s11926-016-0607-7Disclosure of Interests:None declared

Monitoring geriatric dogs after intravenous gadolinium-containing contrast media administration for magnetic resonance imaging

2018 ◽  
Vol 280 ◽  
pp. S73
Author(s):  
Ruxandra Georgiana Tudor ◽  
Andra Degan ◽  
Catalin Ivascu ◽  
Alexandru Neagu ◽  
Ruxandra Costea ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Contrast Media ◽  
Resonance Imaging ◽  
Contrast Media Administration
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