Article
The influence of age on the prevalence of inflammatory and post-inflammatory MRI lesions in the sacroiliac joints of patients with and without axial spondyloarthritis
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Authors
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Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet, Herne; Ruhr-Universität Bochum, Bochum
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Styliani Tsiami
- Rheumazentrum Ruhrgebiet, Herne; Ruhr-Universität Bochum, Bochum
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Anna Kühn
- Rheumazentrum Ruhrgebiet, Herne; Ruhr-Universität Bochum, Bochum
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Martin Fruth
- MVZ blikk Radiologie Herne, Herne
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Jürgen Braun
- Rheumazentrum Ruhrgebiet, Herne; Ruhr-Universität Bochum, Bochum
| Published: | September 14, 2021 |
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Outline
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Objectives: To compare the influence of age on the prevalence of inflammatory and structural magnetic resonance imaging (MRI) changes in the sacroiliac joint (SIJ) of patients with chronic low back pain diagnosed with axial spondyloarthritis (axSpA) or non-SpA.
Methods: MRIs of the SIJ of patients referred for differential diagnosis of back pain who were finally diagnosed with axSpA or not by experienced rheumatologists, were evaluated using semi-coronal STIR and T1-weighted MRI sequences. All images were scored blinded to, age, sex and diagnosis for the occurrence of bone marrow edema (BME), fat lesions (FL), erosions and ankylosis on the level of SIJ-quadrants (SIJ-Q). Patient groups were built based on decade of age (until 29, 30-39, 40-49 and ≥50 years).
Results: A total of 309 patients (175 axSpA and 134 non-SpA) with complete MRI sets were included in the analysis. The mean age was 38.5±11.4 and 43.4±13.8, 66.9% and 35.8% were male, the mean CRP was 1.6±2.4 and 1.1±2.1mg/dl and the median back pain symptom duration was 48 and 60 months, respectively. The number of SIJ-Q with BME and erosions was significantly higher in axSpA vs. non-SpA independent of the age group (Table). In comparison, with exception of the patients in the oldest population (≥50 years), the number of SIJ-Q with FL and the number of patients with at least one FL was not different between subgroups, while the number of erosions and FL but not BME was higher in both groups with increasing age. In the univariate analysis, only female sex was significantly associated with higher occurrence of FL.
Conclusion: Despite a relatively high prevalence in non-SpA patients, BME and erosions were significantly more frequent in axSpA independent of age, while the presence of FL was not different between groups. FL and erosions are increasingly found in older age groups independent of diagnosis. These data are relevant for the interpretation of MRI findings in the SIJ of patients suspicious of axSpA.
Disclosures: None declared
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