MRI & Axial Spondyloarthritis: Experts Discuss Controversies in the Diagnostic Evaluation of axSpA

He concluded his talk by stating that physiological variation in controls is now well documented, and that experience is the key to deciphering the extensive range of anatomical and physiological variation on MRI of the sacroiliac joints. Although high-resolution 3D imaging of the erosions may offer more specific detection of inflammation due to SpA, it will also reveal more, small “erosion-like” lesions in normal subjects, therefore increasing the risk of overdiagnosis, Dr. Lambert said, which is a real concern.

Dr. Lambert noted that 90% of the time he is brought in to provide a second opinion, the patient has incorrectly diagnosed with a spondyloarthropathy.

Lara C. Pullen, PhD, is a medical writer based in the Chicago area.

References

1. Baraliakos X, Richter A, Feldmann D, et al. Frequency of MRI changes suggestive of axial spondyloarthritis in the axial skeleton in a large population-based cohort of individuals aged <45 years. Ann Rheum Dis. 2020 Feb;79(2):186–192.
2. Weber U, Lambert RGW, Pedersen SJ, etc. Assessment of structural lesions in sacroiliac joints enhances diagnostic utility of magnetic resonance imaging in early spondylarthritis. Arthritis Care Res (Hoboken). 2010 Dec;62(12):1763–1771.