Most Read Articles
14 Dec 2017
The coexistence of fibromyalgia in patients with axial spondyloarthritis (axSpA) exerts a negative effect on response to tumour necrosis factor blocker, according to a study. This effect appears to be associated with the self-reported instruments used in fibromyalgia evaluation rather than a different treatment effect of the agent in this population.

Repeat imaging of sacroiliac joints not useful in diagnostic workup of axSpA

01 Oct 2018

The usefulness of repeating magnetic resonance imaging (MRI) of the sacroiliac joints (MRI-SI) after 3 months or 1 year in the diagnostic workup of chronic back pain patients suspected of axial spondyloarthritis (axSpA) appears to be limited, according to data from the SPACE cohort. Specifically, only a small percentage of patients exhibit changes in MRI-SI status.

A total of 188 patients with chronic back pain (mean age 31.0 years; 38.3 percent male; symptom duration, 13.2 months) underwent evaluation of all SpA‐features and repeated MRI‐SI at baseline, 3 months and 1 year. Thirty-one patients (16.5 percent) were MRI‐SI‐positive at baseline. MRI‐SI positivity was evaluated according to Assessment of SpondyloArthritis International Society (ASAS).

MRI-SI status changed from positive to negative in 3/27 patients (11.1 percent) after 3 months and in 11/29 patients (37.9 percent) after 1 year. This change was partly induced by antitumour necrosis factor therapy initiation.

On the other hand, status changed from negative to positive in 5/116 patients (4.3 percent) after 3 months and in 10/138 patients (7.2 percent) after 1 year.

On generalized estimating equation analysis, HLA‐B27‐positivity and male gender emerged as independent determinants of a positive MRI-SI at any time point (42 percent in HLA‐B27-positive males; 6 percent in HLA‐B27-negative females).

Meanwhile, MRI-SI status at baseline strongly predicted MRI-SI status at follow-up, such that a negative status at baseline predicted a very low likelihood of a positive MRI during follow‐up (max, 7 percent).

The present data suggest that the usefulness of repeating a negative MRI in terms of diagnostic yield is low, although there are different risks related to sex and HLA-B27 status, researchers said.

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Most Read Articles
14 Dec 2017
The coexistence of fibromyalgia in patients with axial spondyloarthritis (axSpA) exerts a negative effect on response to tumour necrosis factor blocker, according to a study. This effect appears to be associated with the self-reported instruments used in fibromyalgia evaluation rather than a different treatment effect of the agent in this population.