Short-term Repeat Magnetic Resonance Imaging Scans in Suspected Early Axial Spondyloarthritis Are Clinically Relevant Only in HLA-B27-positive Male Subjects

Raj Sengupta; Helena Marzo-Ortega; Dennis McGonagle; Alison Wadeley; Alexander N Bennett; British Society for Spondyloarthritis

doi:10.3899/jrheum.170171

Short-term Repeat Magnetic Resonance Imaging Scans in Suspected Early Axial Spondyloarthritis Are Clinically Relevant Only in HLA-B27-positive Male Subjects

J Rheumatol. 2018 Feb;45(2):202-205. doi: 10.3899/jrheum.170171. Epub 2017 Dec 1.

Authors

Raj Sengupta^{1

2}, Helena Marzo-Ortega^{1

2}, Dennis McGonagle^{1

2}, Alison Wadeley^{1

2}, Alexander N Bennett^{3

4}; British Society for Spondyloarthritis

Affiliations

¹ From the Royal National Hospital for Rheumatic Diseases, Bath; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds; Culture and Environment College of Liberal Arts, Bath Spa University, Bath; Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Headley Court, Epsom; University of Bath, Bath, UK.
² R. Sengupta, MBBS, PGCME, FRCP, Royal National Hospital for Rheumatic Diseases, and University of Bath; H. Marzo-Ortega, LMS, MRCP, PhD, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; D. McGonagle, FRCPI, PhD, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; A. Wadeley, PhD, Culture and Environment College of Liberal Arts, Bath Spa University; A.N. Bennett, FRCP, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre.
³ From the Royal National Hospital for Rheumatic Diseases, Bath; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds; Culture and Environment College of Liberal Arts, Bath Spa University, Bath; Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Headley Court, Epsom; University of Bath, Bath, UK. alexander.n.bennett@btinternet.com.
⁴ R. Sengupta, MBBS, PGCME, FRCP, Royal National Hospital for Rheumatic Diseases, and University of Bath; H. Marzo-Ortega, LMS, MRCP, PhD, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; D. McGonagle, FRCPI, PhD, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; A. Wadeley, PhD, Culture and Environment College of Liberal Arts, Bath Spa University; A.N. Bennett, FRCP, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre. alexander.n.bennett@btinternet.com.

PMID: 29196379
DOI: 10.3899/jrheum.170171

Abstract

Objective: Our study investigated the natural history of magnetic resonance imaging (MRI)-determined bone marrow edema over a 12-week period in individuals with suspected axial spondyloarthritis.

Methods: There were 109 MRI scans performed on 30 patients who fulfilled the Assessment of Spondyloarthritis international Society inflammatory back pain criteria at baseline and at 4, 8, and 12 weeks.

Results: There were 29 patients who completed the study. Only 4 (14%) patients changed from MRI-negative to MRI-positive (all HLA-B27-positive, OR 2.74). Three of 7 (43%) male HLA-B27-positive patients, 1 of 8 (12.5%) HLA-B27-positive female patients, and no HLA-B27-negative patients changed from MRI- negative to -positive.

Conclusion: Repeat MRI scans within a 12-week period should be considered in HLA-B27-positive males.

Keywords: AXIAL SPONDYLOARTHRITIS; DIAGNOSIS; MAGNETIC RESONANCE IMAGING.

MeSH terms

Back Pain / diagnostic imaging
Bone Marrow Diseases / diagnostic imaging
C-Reactive Protein / analysis
Edema / diagnostic imaging
Female
Follow-Up Studies
HLA-B27 Antigen / analysis*
Humans
Magnetic Resonance Imaging / methods*
Male
Patient Reported Outcome Measures
Sacroiliitis / diagnostic imaging
Sex Factors
Spondylitis, Ankylosing / blood
Spondylitis, Ankylosing / diagnostic imaging*

Substances

HLA-B27 Antigen
C-Reactive Protein