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'MRI-tis' in the early diagnosis of axial SpA: issues and limitations

Nature Reviews Rheumatology volume 6, pages 666–669 (2010)Cite this article

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Abstract

Sacroiliitis on conventional radiography, a key diagnostic feature of axial spondyloarthritis (SpA), often appears only late in the disease course. With the introduction of potent biologic agents that may also be effective in early disease, diagnostic techniques that can identify SpA early in the disease course would be highly beneficial to patients. MRI has been proposed as a novel diagnostic tool for early axial SpA based on the visualization of active inflammatory lesions in established axial SpA, as well as in pre-radiographic axial SpA. Accordingly, MRI is already widely used in clinical practice and has been included in new classification criteria. However, the specificity and predictive value of MRI lesions for the development of axial SpA remain to be fully defined and validated. Most data come from cross-sectional analyses and have not been validated in prospective studies, and the few available prospective studies were performed in highly selected patient populations and have assessed the value of MRI for the prediction of sacroiliitis rather than axial SpA. Also, some studies have indicated considerable diversity in the pattern and extent of MRI lesions, and suggest that many lesions are not specific for SpA. Prospective, longitudinal studies are needed to validate the utility of this new imaging modality for the diagnosis of axial SpA.

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Acknowledgements

L. De Rycke and D. Baeten are supported by grants from The Netherlands Organisation for Scientific Research.

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Authors and Affiliations

  1. Department of Clinical Immunology and Rheumatology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Leen De Rycke, Paul P. Tak & Dominique Baeten

  2. Department of Radiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Mario Maas

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  1. Leen De Rycke
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L. De Rycke, M. Maas and D. Baeten researched data for the article. All authors made substantial contributions to discussion of the content. L. De Rycke, P. P. Tak and D. Baeten wrote the article. All authors contributed to review/editing of the manuscript before submission.

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Correspondence to Dominique Baeten.

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De Rycke, L., Maas, M., Tak, P. et al. 'MRI-tis' in the early diagnosis of axial SpA: issues and limitations. Nat Rev Rheumatol 6, 666–669 (2010). https://doi.org/10.1038/nrrheum.2010.161

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