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Discordant inflammatory changes in the apophyseal and sacroiliac joints: serial observations in enthesitis-related arthritis

Bray, TJ; Amies, T; Vendhan, K; Humphries, P; Sen, D; Ioannou, Y; Hall-Craggs, MA; (2016) Discordant inflammatory changes in the apophyseal and sacroiliac joints: serial observations in enthesitis-related arthritis. British Journal of Radiology , 89 (1065) , Article 20160353. 10.1259/bjr.20160353. Green open access

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Abstract

OBJECTIVE: 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). METHODS: A retrospective study was performed with institutional review board approval. 31 young patients 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 AJs 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. In addition, the correlation between change in SIJ STIR score (Δnfla) and change in AJ score (ΔAJ) was assessed using Spearman's correlation coefficient. RESULTS: 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 Δnfla and ΔAJ (R = 0.14, p = 0.37). CONCLUSION: 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. ADVANCES IN KNOWLEDGE: Inflammation may behave differently at different anatomical sites. The SIJs and AJs should both be imaged in patients with ERA with back pain.

Type: Article
Title: Discordant inflammatory changes in the apophyseal and sacroiliac joints: serial observations in enthesitis-related arthritis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1259/bjr.20160353
Publisher version: http://doi.org/10.1259/bjr.20160353
Language: English
Additional information: Copyright © 2017 The Authors. Published by the British Institute of Radiology. All rights reserved. Republished with permission of British Institute of Radiology, © 2017, from http://www.birpublications.org/doi/10.1259/bjr.20160353
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 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/1504740
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