Department of Radiology, Charité - Universitätsmedizin Berlin.
Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin.
Rheumatology (Oxford). 2023 Mar 1;62(3):1117-1123. doi: 10.1093/rheumatology/keac282.
To assess the impact of joint shape variations on inflammatory lesions on SI joint MRIs in patients with axial spondyloarthritis (axSpA).
A total of 1194 patients from four different prospective cohorts were evaluated, with 684 (57.3%) having sufficient imaging data for inclusion (379 axSpA, 305 controls). All images were evaluated for joint form, erosion, sclerosis, fat metaplasia and bone marrow oedema (BMO) by two independent readers. Logistic regression analyses were used to assess the association of joint form and lesions on imaging for axSpA patients and controls.
Atypical joint forms were common in both axSpA (43.5% [154/354]) and control patients (44.2% [134/303]); both intra-articular variants and a crescent joint shape were significantly more common in axSpA patients (18.4% vs 11.6% and 11.0% vs 5.3.%, respectively; P < 0.001). The axSpA patients with intra-articular joint form variants had 2-fold higher odds of exhibiting erosions [odds ratio (OR) 2.09 (95% CI 1.18, 3.69)] and BMO [OR 1.79 (95% CI 1.13, 2.82)]; this association was not observed in controls. Accessory joints increased the odds for sclerosis in axSpA patients [OR 2.54 (95% CI 1.10, 5.84)] and for sclerosis [OR 17.91 (95% CI 6.92, 46.37)] and BMO [OR 2.05 (95% CI 1.03, 4.07)] in controls.
Joint form variations are associated with the presence of inflammatory lesions on SI joint MRIs of axSpA patients. This should be taken into consideration in future research on the interplay of mechanical strain and inflammation in axSpA.
评估关节形状变化对强直性脊柱炎（axSpA）患者骶髂关节 MRI 上炎症病变的影响。
共评估了来自四个不同前瞻性队列的 1194 名患者，其中 684 名（57.3%）有足够的影像学数据纳入（379 名 axSpA，305 名对照组）。两位独立的读者对所有图像进行关节形态、侵蚀、硬化、脂肪化生和骨髓水肿（BMO）评估。采用逻辑回归分析评估关节形态与 axSpA 患者和对照组影像学上的病变关系。
axSpA 患者（43.5%[154/354]）和对照组患者（44.2%[134/303]）均常见关节形态异常；关节内变异和新月形关节形态在 axSpA 患者中更为常见（分别为 18.4%比 11.6%和 11.0%比 5.3%；P<0.001）。具有关节内关节形态变异的 axSpA 患者发生侵蚀的可能性高出 2 倍[比值比（OR）2.09（95%可信区间 1.183.69）]和骨髓水肿（OR 1.79（95%可信区间 1.132.82））；对照组未见这种关联。副关节增加 axSpA 患者硬化的可能性[OR 2.54（95%可信区间 1.105.84）]和硬化[OR 17.91（95%可信区间 6.9246.37）]和骨髓水肿[OR 2.05（95%可信区间 1.03~4.07）]）对照组。
关节形态变化与 axSpA 患者骶髂关节 MRI 上炎症病变的存在相关。在未来关于机械应变和炎症在 axSpA 中的相互作用的研究中，应考虑这一点。
