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Publication Detail
Discordant Inflammatory Change in the Apophyseal and Sacroiliac Joints: Serial Observations in Enthesitis-related Arthritis.
  • Publication Type:
    Journal article
  • Publication Sub Type:
  • Authors:
    Bray TJ, Amies T, Vendhan K, Humphries P, Sen D, Ioannou Y, Hall-Craggs MA
  • Publication date:
  • Pagination:
  • Journal:
    The British journal of radiology
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  • Print ISSN:
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  • Addresses:
    1 Centre for Medical Imaging, University College London.
To determine the extent to which inflammation of the sacroiliac joints (SIJs) and apophyseal joints (AJs) changes concordantly after treatment in enthesitis-related arthritis (ERA).A retrospective study was performed with Institutional Review Board approval. 31 young people with ERA who had been scanned between March 2009 and November 2014 were included. All patients had post-contrast imaging of the SIJs and lumbar spine and short tau inversion recovery (STIR) images of the SIJs. The severity of sacroiliitis was scored using a modification of an established technique, and inflammation of the apophyseal joints was evaluated using a recently described grading system. The changes in SIJ and AJ scores after treatment were classified as either concordant or discordant, and the proportion of scan-pairs in these groups was recorded. Additionally, the correlation between change in SIJ STIR score and change in AJ score was assessed using Spearman's correlation coefficient.Of a total of 43 scan pairs, the changes in inflammation were concordant in 16 scan pairs and discordant in 27 scan pairs. There was no significant correlation between change in SIJ STIR score (ΔSIJ) and change in AJ score (ΔAJ) (R=0.14, p=0.37).Inflammatory changes in the SIJs and AJs are often discordant. This may be a reason why patients experience ongoing back pain despite apparent improvement in one or the other site.Inflammation may behave differently at different anatomical sites. The SIJs and AJs should both be imaged in ERA patients with back pain.
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