Becker-Capeller D, El-Nawab-Becker S, Hul M, Weber N, Kapsimalakou S, Baraliakos X
Rheumatologic Practice, Klinik Dr Hancken GmbH, Stade, Germany.
Rheumatologic Practice, Private Practice "Links der Elbe", Hamburg, Germany.
Scand J Rheumatol. 2025 Mar;54(2):112-116. doi: 10.1080/03009742.2024.2412890. Epub 2024 Oct 29.
To investigate a potentially primary involvement of the facet joints (FJs) in axial spondyloarthritis (axSpA) development, by studying inflammatory and structural magnetic resonance imaging (MRI) and radiographic changes in the sacroiliac joints (SIJs) and lumbar spine, focusing on FJs, in newly diagnosed radiographic axSpA over a 3 year period.
Twenty-four patients (14 male, 10 female; mean ± sd age 33.75 ± 8.6 years) with radiologically and MRI-confirmed axSpA according to modified New York and Assessment of SpondyloArthritis international Society criteria, with a symptom duration < 5.5 years at baseline (t0), were followed up after 3 years (t1) by rheumatologists and radiologists with axSpA MRI experience > 15 years. The Berlin MRI score was extended by an inflammation score of the lumbar FJs. Clinical assessments were performed.
Radiographic SIJs and syndesmophyte progression increased significantly between t0 and t1. MRI progression of the SIJs between t0 and t1 showed increasing bone marrow oedema (BME), significant fat lesion progression, and significant increases in sclerosis and erosion. In the lumbar spine, BME and fat lesions decreased while erosions in the vertebral units (VUs) significantly increased. Facet joint inflammation (FJI) in t0 significantly influenced MRI changes in VU bone proliferation at t1. Biologicals had no effect on MRI changes from t0 to t1.
Structural MRI changes in the SIJs and lumbar VUs, and radiographic axSpA progression, developed significantly within 3 years. MRI-detected lumbar FJI in early disease is associated with MRI signs of VU bone proliferation, indicating a risk of potential ossification.
通过研究骶髂关节（SIJ）和腰椎的炎症及结构磁共振成像（MRI）以及放射学改变，重点关注小关节（FJ），对新诊断的放射学轴向脊柱关节炎（axSpA）患者进行为期3年的研究，以调查小关节在轴向脊柱关节炎发展中可能的原发性参与情况。
根据改良纽约标准和国际脊柱关节炎评估协会标准，对24例（14例男性，10例女性；平均±标准差年龄33.75±8.6岁）放射学和MRI确诊的axSpA患者进行研究，这些患者在基线时（t0）症状持续时间<5.5年，3年后（t1）由具有超过15年axSpA MRI经验的风湿病学家和放射科医生进行随访。柏林MRI评分通过腰椎FJ的炎症评分进行扩展。进行了临床评估。
t0和t1之间，放射学SIJ和韧带骨赘进展显著增加。t0和t1之间SIJ的MRI进展显示骨髓水肿（BME）增加、脂肪病变进展显著以及硬化和侵蚀显著增加。在腰椎，BME和脂肪病变减少，而椎体单元（VU）的侵蚀显著增加。t0时的小关节炎症（FJI）显著影响t1时VU骨增殖的MRI变化。生物制剂对t0到t1的MRI变化没有影响。
SIJ和腰椎VU的结构MRI变化以及放射学axSpA进展在3年内显著发展。疾病早期MRI检测到的腰椎FJI与VU骨增殖的MRI征象相关，表明存在潜在骨化风险。
