V. Furer, MD, D. Levartovsky, MD, J. Wollman, MD, I. Wigler, MD, D. Paran, MD, I. Kaufman, MD, O. Elalouf, MD, S. Borok, MD, M. Anouk, MD, H. Sarbagil-Maman, MD, M. Berman, MD, A. Polachek, MD, O. Elkayam, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv;
V. Furer, MD, D. Levartovsky, MD, J. Wollman, MD, I. Wigler, MD, D. Paran, MD, I. Kaufman, MD, O. Elalouf, MD, S. Borok, MD, M. Anouk, MD, H. Sarbagil-Maman, MD, M. Berman, MD, A. Polachek, MD, O. Elkayam, MD, Department of Rheumatology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.
J Rheumatol. 2021 Jul;48(7):1014-1021. doi: 10.3899/jrheum.200961. Epub 2021 Jan 15.
To establish the prevalence of nonradiographic sacroiliitis within a real-life sample of patients with psoriatic arthritis (PsA), using pelvic radiographs and magnetic resonance imaging (MRI) of sacroiliac joints (SIJs).
This cross-sectional study included 107 consecutive adults with PsA (Classification Criteria for Psoriatic Arthritis criteria). Participants completed clinical and laboratory evaluation, pelvic radiographs scored for radiographic sacroiliitis according to the modified New York (mNY) criteria, and noncontrast MRI of SIJs, scored by the Berlin score and categorized into active sacroiliitis using the 2016 Assessment of Spondyloarthritis international Society (ASAS) criteria and the presence of structural sacroiliitis.
Radiographic sacroiliitis/mNY criteria were detected in 28.7% (n = 29), confirmed by MRI-detected structural lesions in 72.4% (n = 21). Active sacroiliitis was detected by MRI in 26% (n = 28) of patients, with 11% (n = 11) qualifying for nonradiographic sacroiliitis. Patients with radiographic and nonradiographic sacroiliitis had similar clinical characteristics, except for a longer duration of psoriasis (PsO) and PsA in the radiographic subgroup (PsO: 23.8 ± 12.5 vs 14.1 ± 11.7 yrs, = 0.03; PsA: 12.3 ± 9.8 vs 4.7 ± 4.5 yrs, = 0.02, respectively). Inflammatory back pain (IBP) was reported in 46.4% (n = 13) with active sacroiliitis and 27% (n = 3) with nonradiographic sacroiliitis. The sensitivity of IBP for detection of nonradiographic sacroiliitis was low (27%) and moderate for radiographic sacroiliitis (52%), whereas specificity ranged from 72% to 79% for radiographic and nonradiographic sacroiliitis, respectively.
The prevalence of active sacroiliitis among a real-life population of patients with PsA was 26%. However, the prevalence of nonradiographic sacroiliitis was low (11%) compared to the radiographic sacroiliitis (28.7%) seen in patients with longer disease duration. IBP was not a sensitive indicator for the presence of early-stage sacroiliitis that was commonly asymptomatic.
使用骨盆 X 线片和磁共振成像（MRI）评估骶髂关节（SIJ），在真实的银屑病关节炎（PsA）患者样本中确定非放射性骶髂关节炎的流行率。
这项横断面研究纳入了 107 名连续的成年 PsA 患者（银屑病关节炎分类标准）。参与者完成了临床和实验室评估，根据改良纽约（mNY）标准对骨盆 X 线片进行放射性骶髂关节炎评分，以及非对比性 SIJ 的 MRI，根据柏林评分进行评分，并根据 2016 年评估脊柱关节炎国际协会（ASAS）标准和结构骶髂关节炎的存在将其分为活跃性骶髂关节炎。
28.7%（n=29）的患者检测到放射学骶髂关节炎/mNY 标准，72.4%（n=21）的患者通过 MRI 检测到结构病变得到证实。26%（n=28）的患者通过 MRI 检测到活跃性骶髂关节炎，其中 11%（n=11）符合非放射性骶髂关节炎的标准。影像学和非影像学骶髂关节炎的患者具有相似的临床特征，除了影像学亚组的银屑病（PsO）和 PsA 持续时间更长（PsO：23.8±12.5 与 14.1±11.7 年，=0.03；PsA：12.3±9.8 与 4.7±4.5 年，=0.02）。有活动性骶髂关节炎的患者中 46.4%（n=13）报告有炎症性背痛（IBP），而无放射性骶髂关节炎的患者中 27%（n=3）报告有 IBP。IBP 对非放射性骶髂关节炎的检出敏感性较低（27%），对放射性骶髂关节炎的检出敏感性中等（52%），而对放射性和非放射性骶髂关节炎的特异性分别为 72%至 79%。
在真实的银屑病关节炎患者人群中，活动性骶髂关节炎的患病率为 26%。然而，与病程较长的患者中观察到的放射性骶髂关节炎（28.7%）相比，非放射性骶髂关节炎的患病率较低（11%）。IBP 不是早期无症状骶髂关节炎存在的敏感指标。
