The incidence of bone marrow oedema at the sacroiliac joints in a non-rheumatological population — a retrospective cohort study

Abstract

BackgroundThe purpose of this study is to determine the incidence of bone marrow oedema (BME) at magnetic resonance imaging (MRI) of the sacroiliac joints (SIJ) in a non- rheumatological population, and to explore whether patient-reported outcome measures are suitable for predicting BME at the SIJ at referral. Furthermore, to investigate the final clinical diagnoses three months after initial SIJ MRI.MethodsThis study was a retrospective cohort study consisting of patients 18–45 years of age that were referred for a SIJ MRI between 1 July 2016 to 30 June 2017 at the Department of Radiology in Lillebaelt Hospital, Denmark. The SIJ MRI radiological reports were evaluated for signs of BME. Principal and secondary diagnoses according to the 10th version of International Classification of Diseases (ICD-10)—three months after the initial MRI—were identified in the electronic patient record system. For a subgroup of patients, patient- reported outcome measures, such as the 23-item Roland Morris Disability Questionnaire, quality of life and pain intensity in the back and leg were included from the local SpineData database.ResultsIn total, 333 patients were included, and 187 (56.2%) of those patients received a final diagnosis within three months after the SIJ MRI. BME was detected in 63 (18.9%) patients; 17 (9.1%) patients had both BME at SIJ MRI and were diagnosed with spondyloarthritis (M45/M46). There was no statistically significant difference between patients with and without BME regarding demographics, quality of life, pain descriptions or function.ConclusionsThe incidence of BME in the cohort correlates well to previous studies regarding the incidence of SIJ MRI changes in non-rheumatological populations in Denmark. Patient-reported outcome measures do not seem to contribute to identifying patients with early-phase BME in a non-rheumatological population.

The Prevalence of MRI-Defined Sacroiliitis and Classification of Spondyloarthritis in Patients with Acute Anterior Uveitis: A Longitudinal Single-Centre Cohort Study

“…We detected significantly more frequent BME in patients with AAU compared to HS, which could be caused by the proportion of patients later diagnosed with axSpA, despite the fact that a subset of HS performed more regular sports activity than patients with AAU. The presence of BME at SIJ in healthy subjects was comparable to the incidence of BME at SIJ in the non-rheumatological population [ 23 ]. Highly suggestive BME was present only in patients with AAU; however, six patients without chronic back pain could not be classified as axSpA.…”

“…BME on SIJ is the first and the most typical axSpA feature which can be found on MRI. However, BME lacks sufficient level of specificity due to its manifestation in other non-rheumatological and non-inflammatory conditions [ 23 ]. Therefore, integrating “highly suggestive” BME into the criteria for axSpA has been validated [ 17 ].…”

Role of MRI in Diagnosis of Sacro-iliac Joint Lesions

“…Nygaard et al [9] showed that the mean age of the population was 33.1 years of age (standard deviation (SD): 7.89), The groups primarily consisted of women in both groups…”