Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Center of Head and Orthopedics, Rigshospitalet, Glostrup.
Department of Clinical Medicine, University of Copenhagen, Copenhagen.
Rheumatology (Oxford). 2022 Mar 2;61(3):1005-1017. doi: 10.1093/rheumatology/keab468.
To investigate SI joint MRI inflammation, structural and degenerative lesion characteristics in patients with axial spondyloarthritis (axSpA) and various control groups.
Patients with axSpA (n = 41) and lumbar disc herniation (n = 25), women with (n = 46) and without (n = 14) post-partum (childbirth within 4-16 months) buttock/pelvic pain, cleaning assistants (n = 26), long-distance runners (n = 23) and healthy men (n = 29) had MRI of the SI joints prospectively performed. MRI lesions were assessed on nine slices covering the cartilaginous compartment by two experienced readers according to the definitions of the Spondyloarthritis Research Consortium of Canada SI joint inflammation and structural scores, and were evaluated according to depth and extent. Other morphological characteristics were also analysed.
Total depth scores for bone marrow oedema (BME) and fat lesion (FAT) and total extent score for erosion were statistically significantly highest in axSpA, while scores for sclerosis were numerically highest in women with post-partum pain. Maximum BME depth >10 mm was frequently and exclusively found in axSpA and post-partum women (39% vs 14-17%) while FAT depth >5 mm was predominantly found in axSpA (76% vs 0-10%). Erosions were primarily seen in axSpA, especially when extensive (≥4 or confluent; 17% vs 0%). Capsulitis was absent in non-axSpA groups. BME and FAT in the ligamentous compartment were primarily found in axSpA (17/22% vs 0/2% in non-axSpA groups). In non-axSpA, osteophytes (axSpA vs non-axSpA: 0% vs 3-17%) and vacuum phenomenon (7% vs 30-66%) were more frequent, and the joint space was wider [mean (s.d.) 1.5 (0.9) vs 2.2 (0.5) mm].
FAT depth >5 mm, but not BME depth >10 mm, could almost differentiate axSpA patients from all other groups. When excluding post-partum women, BME >5 mm and erosion were highly specific for axSpA.
研究强直性脊柱炎（axSpA）患者和各种对照组的 SI 关节 MRI 炎症、结构和退行性病变特征。
前瞻性地对 axSpA 患者（n=41）和腰椎间盘突出症患者（n=25）、产后（分娩后 4-16 个月内）臀部/骨盆疼痛的女性（n=46）和无产后疼痛的女性（n=14）、清洁助理（n=26）、长跑运动员（n=23）和健康男性（n=29）进行 SI 关节 MRI 检查。两位有经验的读者根据加拿大脊柱关节炎研究协会的 SI 关节炎症和结构评分的定义，对覆盖软骨间隙的 9 个层面进行 MRI 病变评估，并根据深度和范围进行评估。还分析了其他形态特征。
axSpA 的骨髓水肿（BME）总深度评分、脂肪病变（FAT）总深度评分和侵蚀总严重程度评分最高，而产后疼痛女性的硬化评分最高。最大 BME 深度>10mm 频繁且仅见于 axSpA 和产后女性（39% vs 14-17%），而 FAT 深度>5mm 主要见于 axSpA（76% vs 0-10%）。侵蚀主要见于 axSpA，尤其是广泛（≥4 或融合；17% vs 0%）时。非 axSpA 组未见囊带炎。韧带间隙的 BME 和 FAT 主要见于 axSpA（22% vs 非 axSpA 组 0/2%）。非 axSpA 组骨赘（axSpA 与非 axSpA：0% vs 3-17%）和真空现象（7% vs 30-66%）更常见，关节间隙更宽[平均值（标准差）1.5（0.9）vs 2.2（0.5）mm]。
FAT 深度>5mm，但 BME 深度>10mm 几乎可以将 axSpA 患者与其他所有组区分开来。排除产后女性后，BME>5mm 和侵蚀对 axSpA 具有高度特异性。
