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Recommendations for Acquisition and Interpretation of MRI of the Spine and Sacroiliac Joints in the Diagnosis of Axial Spondyloarthritis in the UK

Bray, T; Jones, A; Bennett, A; Conaghan, P; Grainger, A; Hodgson, R; Hutchinson, C; ... Machado, P; + view all (2019) Recommendations for Acquisition and Interpretation of MRI of the Spine and Sacroiliac Joints in the Diagnosis of Axial Spondyloarthritis in the UK. Rheumatology , 58 (10) pp. 1831-1838. 10.1093/rheumatology/kez173. Green open access

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Abstract

Objectives: To develop evidence-based recommendations on the use of MRI in the diagnosis of axial SpA (axSpA). Methods: A working group comprising nine rheumatologists and nine musculoskeletal radiologists with an interest in axSpA was established, with support from the British Society of Spondyloarthritis (BRITSpA). Two meetings were held. In the first meeting, research questions were formulated. In the second meeting, the results of a systematic literature review designed to inform the recommendations were reviewed. An anonymized Delphi process was used to formulate the final set of recommendations. For each recommendation, the level of evidence and strength of recommendation was determined. The level of agreement was assessed using a 010 numerical rating scale. Results: Two overarching principles were formulated, as follows: The diagnosis of axSpA is based on clinical, laboratory and imaging features (overarching principle 1), and patients with axSpA can have isolated inflammation of either the sacroiliac joints or the spine (overarching principle 2). Seven recommendations addressing the use of MRI in the assessment of patients with suspected axSpA were formulated, covering topics including recommended sequences, anatomical coverage, acquisition parameters and interpretation of active and structural MRI lesions. The level of agreement for each recommendation was very high (range 8.89.8). Conclusion: A joint rheumatology and radiology consensus on the acquisition and interpretation of MRI in axSpA diagnosis was achieved, and a research agenda formulated. This consensus should help standardize practice around MRI and ensure a more informed, consistent approach to the diagnosis of axSpA.

Type: Article
Title: Recommendations for Acquisition and Interpretation of MRI of the Spine and Sacroiliac Joints in the Diagnosis of Axial Spondyloarthritis in the UK
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/rheumatology/kez173
Publisher version: https://doi.org/10.1093/rheumatology/kez173
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: spondyloarthritis, sacroiliitis, magnetic resonance imaging, recommendations, diagnosis
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Metabolism and Experi Therapeutics
URI: https://discovery.ucl.ac.uk/id/eprint/10071854
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