Effect of Characteristic Inflammatory and Structural Pelvic Magnetic Resonance Imaging Lesions on Expert Assessment of Axial Juvenile Spondyloarthritis

被引：0

作者：

Mayer, Adam ^{[1
]}

Brandon, Timothy G. ^{[2
]}

Aggarwal, Amita ^{[3
]}

Burgos-Vargas, Ruben ^{[4
]}

Colbert, Robert A. ^{[5
]}

Horneff, Gerd ^{[6
,7
]}

Joos, Rik ^{[8
,9
]}

Laxer, Ronald M. ^{[10
,11
]}

Minden, Kirsten ^{[12
,13
,14
,15
]}

Ravelli, Angelo ^{[16
,17
]}

Ruperto, Nicolino ^{[18
]}

Smith, Judith A. ^{[19
]}

Stoll, Matthew L. ^{[20
]}

Tse, Shirley M. ^{[21
]}

van den Bosch, Filip ^{[22
]}

Maksymowych, Walter P. ^{[23
,24
]}

Lambert, Robert G. ^{[25
]}

Biko, David M. ^{[26
,27
]}

Chauvin, Nancy a. ^{[28
]}

Francavilla, Michael L. ^{[29
]}

Jaremko, Jacob L. ^{[25
,30
]}

Herregods, Nele ^{[31
]}

Kasapcopur, Ozgur ^{[32
]}

Yildiz, Mehmet ^{[32
]}

Srinivasalu, Hemalatha ^{[33
,34
]}

Faerber, Jennifer A. ^{[35
]}

Naden, Ray ^{[36
,37
]}

Hendry, Alison M. ^{[38
]}

Weiss, Pamela F. ^{[39
,40
]}

机构：

[1] Childrens Hosp Philadelphia, Dept Pediat, Div Rheumatol, Philadelphia, PA USA

[2] Childrens Hosp Philadelphia, Dept Pediat, Div Rheumatol & Clin Futures, Philadelphia, PA USA

[3] Sanjay Gandhi Postgrad Inst Med Sci, Dept Clin Immunol & Rheumatol, Lucknow, India

[4] Hosp Gen Mexico Dr Eduardo Ligeaga, Dept Rheumatol, Mexico City, Mexico

[5] NIAMSD, NIH, Bethesda, MD 20817 USA

[6] Asklepios Klin Sankt Augustin, Dept Gen Paediat, St Augustin, Germany

[7] Univ Hosp Cologne, Dept Pediat & Adolescent Med, Cologne, Germany

[8] Univ Hosp Gent, B-9000 Ghent, Belgium

[9] ZNA, Dept Rheumatol, Antwerp, Belgium

[10] St Michaels Hosp, Hosp Sick Children, Toronto, ON, Canada

[11] St Michaels Hosp, Toronto, ON, Canada

[12] Charite Univ Med Berlin, Berlin, Germany

[13] Free Univ Berlin, Berlin, Germany

[14] Humboldt Univ, Dept Pediat Resp Med Immunol & Crit Care Med, Berlin, Germany

[15] Deutsch Rheuma Forschungszentrum Berlin, Berlin, Germany

[16] Univ Genoa, IRCCS Ist Giannina Gaslini, Direz Sci, Genoa, Italy

[17] Univ Genoa, Dipartimento Neurosci Riabilitaz Oftalmol Genet &, Genoa, Italy

[18] Univ Milano Bicocca, Fdn IRCCS San Gerardo Tintori, Monza, Italy

[19] Univ Wisconsin Madison, Sch Med & Publ Hlth, Dept Pediat, Madison, WI USA

[20] Univ Alabama Birmingham, Dept Pediat, Birmingham, AL USA

[21] Univ Toronto, Hosp Sick Children, Dept Paediat, Div Rheumatol, Toronto, ON, Canada

[22] Ghent Univ Hosp, VIB UGent Ctr Inflammat Res, Lab Mucosal Immunol, Ghent, Belgium

[23] Univ Alberta, Dept Med, Edmonton, AB, Canada

[24] CARE Arthrit, Edmonton, AB, Canada

[25] Univ Alberta, Dept Radiol & Diagnost Imaging, Edmonton, AB, Canada

[26] Univ Penn, Childrens Hosp Philadelphia, Dept Radiol, Philadelphia, PA 19104 USA

[27] Univ Penn, Perelman Sch Med, Dept Radiol, Philadelphia, PA USA

[28] Milton S Hershey Childrens Hosp, Penn State Hlth, Hershey, PA USA

[29] Univ S Alabama, Whiddon Coll Med, Dept Pharmacol, Mobile, AL 36688 USA

[30] Univ Alberta, Dept Radiolog & Diagnost Imaging, Edmonton, AB, Canada

[31] Ghent Univ Hosp, Dept Radiol & Nucl Med, Ghent, Belgium

[32] Istanbul Univ Cerrahpasa, Cerrahpasa Med Sch, Dept Pediat Rheumatol, Istanbul, Turkiye

[33] George Washington Univ, Childrens Natl Hosp, Div Rheumatol, Sch Med, Washington, DC USA

[34] NIAMSD, Pediat Translat Res Branch, NIH, Bethesda, MD USA

[35] Childrens Hosp Philadelphia, Dept Biomed & Hlth Informat, Data Sci & Biostat Unit, Philadelphia, PA USA

[36] Auckland City Hosp, Dept Med Obstet Med, Auckland, New Zealand

[37] McMaster Univ, Hamilton, ON, Canada

[38] Counties Manukau Dist Hlth Board, Div Med, Gen Med & Rheumatol, Auckland, New Zealand

[39] Univ Penn, Childrens Hosp Philadelphia, Dept Pediat, Div Rheumatol & & Clin Futures, Philadelphia, PA USA

[40] Univ Penn, Ctr Clin Epidemiol & Biostat, Perelman Sch Med, Philadelphia, PA USA

来源：

JOURNAL OF RHEUMATOLOGY | 2025年 / 52卷 / 02期

基金：

美国国家卫生研究院;

关键词：

magnetic resonance imaging; pediatrics; sacroiliitis; spondyloarthropathy; ONSET ANKYLOSING-SPONDYLITIS; ENTHESITIS-RELATED ARTHRITIS; ADULT-ONSET; SACROILIITIS; DIAGNOSIS; CRITERIA; DISEASE; PAIN;

D O I：

10.3899/jrheum.2024-0696

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective. To evaluate the influence of pelvic magnetic resonance imaging (MRI) findings on axial disease assessment in juvenile spondyloarthritis (JSpA). Methods. This was a cross-sectional study of patients with JSpA with suspected axial disease. Three experts reviewed each case and rated their confidence (-3 to +3) in the presence of axial disease, first with clinical data and second with clinical and MRI data. Agreement was defined as >= 2/3 clinical experts with a rating of <= -1 or >= 1, and high confidence agreement as <= -2 or >= 2. The association of clinical features and both global assessments was tested with modified Poisson regression models. Results. Two hundred seventy-two of 303 cases (89.8%) achieved agreement with clinical data alone. Adding imaging data affected agreement in 38.9% (118/303) and directionality of agreement in 23.4% (71/303). Agreement was facilitated in 26/31 cases and lost in 21/272 cases. Of those 71 cases that changed directionality, 33 changed from axial disease being absent to present and 38 from present to absent. The final model had an area under the receiver-operating characteristic (AUROC) curve of 0.93 and 3 factors were independently associated with expert agreement (HLA-B27: relative risk [RR] 1.41, 95% CI 1.14-1.74; pain improvement with activity: RR 1.27, 95% CI 1.05-1.54; and bone marrow edema on MRI: RR 4.08, 95% CI 2.91-5.73). Conclusion. The addition of imaging data affected directionality and improved high confidence agreement of expert assessment of axial disease. These results underscore the integral role of MRI in the determination of axial disease in JSpA.

引用

页码：165 / 172

页数：8

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