Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group

Robert G W Lambert; Pauline A C Bakker; Désirée van der Heijde; Ulrich Weber; Martin Rudwaleit; Kay-Geert Hermann; Joachim Sieper; Xenofon Baraliakos; Alex Bennett; Jürgen Braun; Rubén Burgos-Vargas; Maxime Dougados; Susanne Juhl Pedersen; Anne Grethe Jurik; Walter P Maksymowych; Helena Marzo-Ortega; Mikkel Østergaard; Denis Poddubnyy; Monique Reijnierse; Filip van den Bosch; Irene van der Horst-Bruinsma; Robert Landewé

doi:10.1136/annrheumdis-2015-208642

Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group

Robert G W Lambert, Pauline A C Bakker, Désirée van der Heijde, Ulrich Weber, Martin Rudwaleit, Kay-Geert Hermann, Joachim Sieper, Xenofon Baraliakos, Alex Bennett, Jürgen Braun, Rubén Burgos-Vargas, Maxime Dougados, Susanne Juhl Pedersen, Anne Grethe Jurik, Walter P Maksymowych, Helena Marzo-Ortega, Mikkel Østergaard, Denis Poddubnyy, Monique Reijnierse, Filip van den BoschIrene van der Horst-Bruinsma, Robert Landewé

Department of Clinical Medicine

215 Citations (Scopus)

Abstract

Objectives To review and update the existing definition of a positive MRI for classification of axial spondyloarthritis (SpA). Methods The Assessment in SpondyloArthritis International Society (ASAS) MRI working group conducted a consensus exercise to review the definition of a positive MRI for inclusion in the ASAS classification criteria of axial SpA. Existing definitions and new data relevant to the MRI diagnosis and classification of sacroiliitis and spondylitis in axial SpA, published since the ASAS definition first appeared in print in 2009, were reviewed and discussed. The precise wording of the existing definition was examined in detail and the data and a draft proposal were presented to and voted on by the ASAS membership. Results The clear presence of bone marrow oedema on MRI in subchondral bone is still considered to be the defining observation that determines the presence of active sacroiliitis. Structural damage lesions seen on MRI may contribute to a decision by the observer that inflammatory lesions are genuinely due to SpA but are not required to meet the definition. The existing definition was clarified adding guidelines and images to assist in the application of the definition. Conclusion The definition of a positive MRI for classification of axial SpA should continue to primarily depend on the imaging features of â € active sacroiliitis' until more data are available regarding MRI features of structural damage in the sacroiliac joint and MRI features in the spine and their utility when used for classification purposes.

Original language	English
Journal	Annals of the Rheumatic Diseases
Volume	75
Issue number	11
Pages (from-to)	1958-1963
Number of pages	6
ISSN	0003-4967
DOIs	https://doi.org/10.1136/annrheumdis-2015-208642
Publication status	Published - 1 Nov 2016

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Lambert, R. G. W., Bakker, P. A. C., van der Heijde, D., Weber, U., Rudwaleit, M., Hermann, K-G., Sieper, J., Baraliakos, X., Bennett, A., Braun, J., Burgos-Vargas, R., Dougados, M., Pedersen, S. J., Jurik, A. G., Maksymowych, W. P., Marzo-Ortega, H., Østergaard, M., Poddubnyy, D., Reijnierse, M., ... Landewé, R. (2016). Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group. Annals of the Rheumatic Diseases, 75(11), 1958-1963. https://doi.org/10.1136/annrheumdis-2015-208642

Lambert, RGW, Bakker, PAC, van der Heijde, D, Weber, U, Rudwaleit, M, Hermann, K-G, Sieper, J, Baraliakos, X, Bennett, A, Braun, J, Burgos-Vargas, R, Dougados, M, Pedersen, SJ, Jurik, AG, Maksymowych, WP, Marzo-Ortega, H, Østergaard, M, Poddubnyy, D, Reijnierse, M, van den Bosch, F, van der Horst-Bruinsma, I & Landewé, R 2016, 'Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group', Annals of the Rheumatic Diseases, vol. 75, no. 11, pp. 1958-1963. https://doi.org/10.1136/annrheumdis-2015-208642

@article{e6e43bc2f63b4e93b670d08880c8a839,

title = "Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group",

abstract = "Objectives To review and update the existing definition of a positive MRI for classification of axial spondyloarthritis (SpA). Methods The Assessment in SpondyloArthritis International Society (ASAS) MRI working group conducted a consensus exercise to review the definition of a positive MRI for inclusion in the ASAS classification criteria of axial SpA. Existing definitions and new data relevant to the MRI diagnosis and classification of sacroiliitis and spondylitis in axial SpA, published since the ASAS definition first appeared in print in 2009, were reviewed and discussed. The precise wording of the existing definition was examined in detail and the data and a draft proposal were presented to and voted on by the ASAS membership. Results The clear presence of bone marrow oedema on MRI in subchondral bone is still considered to be the defining observation that determines the presence of active sacroiliitis. Structural damage lesions seen on MRI may contribute to a decision by the observer that inflammatory lesions are genuinely due to SpA but are not required to meet the definition. The existing definition was clarified adding guidelines and images to assist in the application of the definition. Conclusion The definition of a positive MRI for classification of axial SpA should continue to primarily depend on the imaging features of {\^a} € active sacroiliitis' until more data are available regarding MRI features of structural damage in the sacroiliac joint and MRI features in the spine and their utility when used for classification purposes.",

author = "Lambert, {Robert G W} and Bakker, {Pauline A C} and {van der Heijde}, D{\'e}sir{\'e}e and Ulrich Weber and Martin Rudwaleit and Kay-Geert Hermann and Joachim Sieper and Xenofon Baraliakos and Alex Bennett and J{\"u}rgen Braun and Rub{\'e}n Burgos-Vargas and Maxime Dougados and Pedersen, {Susanne Juhl} and Jurik, {Anne Grethe} and Maksymowych, {Walter P} and Helena Marzo-Ortega and Mikkel {\O}stergaard and Denis Poddubnyy and Monique Reijnierse and {van den Bosch}, Filip and {van der Horst-Bruinsma}, Irene and Robert Landew{\'e}",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.",

year = "2016",

month = nov,

day = "1",

doi = "10.1136/annrheumdis-2015-208642",

language = "English",

volume = "75",

pages = "1958--1963",

journal = "Annals of the Rheumatic Diseases",

issn = "0003-4967",

publisher = "B M J Group",

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TY - JOUR

T1 - Defining active sacroiliitis on MRI for classification of axial spondyloarthritis

T2 - update by the ASAS MRI working group

AU - Lambert, Robert G W

AU - Bakker, Pauline A C

AU - van der Heijde, Désirée

AU - Weber, Ulrich

AU - Rudwaleit, Martin

AU - Hermann, Kay-Geert

AU - Sieper, Joachim

AU - Baraliakos, Xenofon

AU - Bennett, Alex

AU - Braun, Jürgen

AU - Burgos-Vargas, Rubén

AU - Dougados, Maxime

AU - Pedersen, Susanne Juhl

AU - Jurik, Anne Grethe

AU - Maksymowych, Walter P

AU - Marzo-Ortega, Helena

AU - Østergaard, Mikkel

AU - Poddubnyy, Denis

AU - Reijnierse, Monique

AU - van den Bosch, Filip

AU - van der Horst-Bruinsma, Irene

AU - Landewé, Robert

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Objectives To review and update the existing definition of a positive MRI for classification of axial spondyloarthritis (SpA). Methods The Assessment in SpondyloArthritis International Society (ASAS) MRI working group conducted a consensus exercise to review the definition of a positive MRI for inclusion in the ASAS classification criteria of axial SpA. Existing definitions and new data relevant to the MRI diagnosis and classification of sacroiliitis and spondylitis in axial SpA, published since the ASAS definition first appeared in print in 2009, were reviewed and discussed. The precise wording of the existing definition was examined in detail and the data and a draft proposal were presented to and voted on by the ASAS membership. Results The clear presence of bone marrow oedema on MRI in subchondral bone is still considered to be the defining observation that determines the presence of active sacroiliitis. Structural damage lesions seen on MRI may contribute to a decision by the observer that inflammatory lesions are genuinely due to SpA but are not required to meet the definition. The existing definition was clarified adding guidelines and images to assist in the application of the definition. Conclusion The definition of a positive MRI for classification of axial SpA should continue to primarily depend on the imaging features of â € active sacroiliitis' until more data are available regarding MRI features of structural damage in the sacroiliac joint and MRI features in the spine and their utility when used for classification purposes.

AB - Objectives To review and update the existing definition of a positive MRI for classification of axial spondyloarthritis (SpA). Methods The Assessment in SpondyloArthritis International Society (ASAS) MRI working group conducted a consensus exercise to review the definition of a positive MRI for inclusion in the ASAS classification criteria of axial SpA. Existing definitions and new data relevant to the MRI diagnosis and classification of sacroiliitis and spondylitis in axial SpA, published since the ASAS definition first appeared in print in 2009, were reviewed and discussed. The precise wording of the existing definition was examined in detail and the data and a draft proposal were presented to and voted on by the ASAS membership. Results The clear presence of bone marrow oedema on MRI in subchondral bone is still considered to be the defining observation that determines the presence of active sacroiliitis. Structural damage lesions seen on MRI may contribute to a decision by the observer that inflammatory lesions are genuinely due to SpA but are not required to meet the definition. The existing definition was clarified adding guidelines and images to assist in the application of the definition. Conclusion The definition of a positive MRI for classification of axial SpA should continue to primarily depend on the imaging features of â € active sacroiliitis' until more data are available regarding MRI features of structural damage in the sacroiliac joint and MRI features in the spine and their utility when used for classification purposes.

U2 - 10.1136/annrheumdis-2015-208642

DO - 10.1136/annrheumdis-2015-208642

M3 - Journal article

C2 - 26768408

SN - 0003-4967

VL - 75

SP - 1958

EP - 1963

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

IS - 11

ER -

Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group

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