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Findings support use of CT scans of the abdomen as screening tool for sacroiliitis
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Results from this study found CT scans that indicated the presence of ankylosis or showed a total erosion score of at least three could be used to identify patients at high risk of sacroiliitis.
Through a training exercise with 12 CT scans of the sacroiliac joints, researchers identified erosions, sclerosis and ankylosis in patients with radiographic and non-radiographic axial spondyloarthritis. In order to propose a screening tool to identify the discriminating features of sacroiliitis, two blinded readers reviewed 24 CT scans from a derivation cohort. Investigators then used 68 patients in a test cohort to confirm the utility of the tool. For each variable, investigators calculated the inter- and intra-observer values, sensitivity, specificity and positive/negative likelihood ratios. Receiver-operating characteristic curves were used to evaluate erosions.
Results from the derivation cohort analysis showed the determination of the number of erosions on worst coronal slice on each of the four articular surfaces was not inferior compared with the analyzation of the individual slices in either transverse or coronal views. The interreader reliability in the test cohort for both ankylosis and iliac and sacral erosions was very good and was moderate for sclerosis.
According to researchers, the highest sensitivity and specificity for sacroiliitis was a total erosion score of greater than or equal to three. The sensitivity increased and specificity decreased with an addition of greater than 0.5 cm of lilac sclerosis or of greater than 0.3 cm of sacral sclerosis. ‒ by Monica Jaramillo
Disclosure: The research was supported by an Assessment of Spondyloarthritis International Society fellowship grant and in part by Janssen.
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