Publication Details
Abstract
Background: Magnetic Resonance Imaging (MRI) has become essential in detecting sacroiliac joint inflammation, identifying lesions before structural changes appear on radiography or CT. The Assessment of SpondyloArthritis International Society (ASAS) criteria introduced in 2009 provided a simple definition of active sacroiliitis for axial spondyloarthritis (axSpA) diagnosis, gaining wide acceptance in clinical practice.
Objectives: To determine the prevalence of sacroiliitis according to ASAS criteria in patients presenting with lower back pain and evaluate the diagnostic performance of the T1-weighted high-resolution isotropic volume examination (THRIVE) MRI sequence compared to the conventional T1-weighted sequence in diagnosing axial spondyloarthritis.
Patients and Methods: This prospective cross-sectional study involved 83 patients with suspected axSpA, conducted from February to November 2023 at Gazi Al-Hariri Teaching Hospital, Baghdad. Clinical history, serological tests (HLA-B27, CRP), and detailed MRI findings (osteitis, sclerosis, fat deposition, ankylosis, erosions, joint space narrowing) were collected and assessed.
Results: The mean age was 35.1 years (±9.4), with females comprising 51.8% of the sample. Inflammatory back pain was significantly more prevalent in males (P < 0.05). Among participants, 21 (25.3%) were classified as axSpA based on clinical criteria, while 18 (21.1%) met the imaging criteria. The THRIVE sequence was significantly superior to the conventional T1 sequence in detecting sacroiliac joint erosions (P = 0.01).
Conclusions: MRI-defined active sacroiliitis remains crucial for axial SpA diagnosis. The THRIVE MRI sequence demonstrates higher sensitivity and improved detection of erosions and joint-space changes compared to conventional T1-weighted imaging, highlighting its potential clinical advantage for evaluating patients with suspected axial spondyloarthritis.