Hecquet Sophie, Lustig Jean-Philippe, Verhoeven Frank, Chouk Mickaël, Aubry Sébastien, Wendling Daniel, Prati Clément
Department of Rheumatology, CHU, 3 Boulevard Alexandre Fleming, 25000 Besançon, France.
Department of Radiology, CHU, Besançon, France.
Ther Adv Musculoskelet Dis. 2022 Sep 5;14:1759720X221119245. doi: 10.1177/1759720X221119245. eCollection 2022.
Lesions detected by magnetic resonance imaging (MRI) of the sacroiliac joints are critical to the diagnosis of non-radiographic axial spondyloarthritis. However, inflammatory and structural lesions may be encountered in other conditions.
The objective of this study was to evaluate and compare the frequency and localization of inflammatory and structural lesions on MRIs of the sacroiliac joint of spondyloarthritis (SpA) and non-spondyloarthritis (non-SpA) patients.
This is a retrospective study including 200 patients, each having undergone an MRI of the sacroiliac joints.
Two experienced readers evaluated the whole set of images to detect erosions, subchondral sclerosis, fatty lesions, bone marrow edema (BME) and ankylosis according to the definitions established by the ASAS MRI working group. We divided sacroiliac joints into five segments: upper, antero-middle, intermediate-middle, postero-middle and lower.
A total of 96 subjects with SpA (mean age 37.4 ± 11.8 years) and 104 without SpA (mean age 39.9 ± 11.6 years) were included. Of the 96 SpA patients, 65% had inflammatory buttock pain compared with 25% in the non-SpA group. BME was seen in 65% of SpA patients, mainly in the intermediate-middle segment, and in 20% of non-SpA patients, predominantly in the antero-middle segment. Subchondral sclerosis occurred in 44% of non-SpA patients, mostly in the antero-middle segment, and in 36% of SpA patients. Fatty lesions were present in 34% of SpA and in 21% of non-SpA patients. Erosions were seen in 25% of non-SpA and in 60% of SpA patients. BME and structural lesions were minimally observed in the postero-middle segment in non-SpA patients.
Inflammatory and structural lesions were observed in all segments of the joint in SpA, mainly in the middle segments, while lesions predominantly affected the antero-middle segment in non-SpA, and were uncommon in the postero-middle segment.
骶髂关节磁共振成像（MRI）检测到的病变对于非放射学轴向脊柱关节炎的诊断至关重要。然而，在其他情况下也可能出现炎症性和结构性病变。
本研究的目的是评估和比较脊柱关节炎（SpA）和非脊柱关节炎（非SpA）患者骶髂关节MRI上炎症性和结构性病变的频率及定位。
这是一项回顾性研究，纳入了200例均接受过骶髂关节MRI检查的患者。
两名经验丰富的阅片者根据ASAS MRI工作组制定的定义，评估整套图像以检测侵蚀、软骨下硬化、脂肪病变、骨髓水肿（BME）和强直。我们将骶髂关节分为五个节段：上部、前中部、中中部、后中部和下部。
共纳入96例SpA患者（平均年龄37.4±11.8岁）和104例非SpA患者（平均年龄39.9±11.6岁）。在96例SpA患者中，65%有炎性臀部疼痛，而非SpA组为25%。65%的SpA患者可见BME，主要位于中中部节段，20%的非SpA患者可见BME，主要位于前中部节段。44%的非SpA患者出现软骨下硬化，大多位于前中部节段，36%的SpA患者出现软骨下硬化。34%的SpA患者和21%的非SpA患者存在脂肪病变。25%的非SpA患者和60%的SpA患者可见侵蚀。非SpA患者在后中部节段极少观察到BME和结构性病变。
SpA患者关节的所有节段均观察到炎症性和结构性病变，主要位于中部节段，而非SpA患者的病变主要影响前中部节段，在后中部节段不常见。
