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Bone marrow edema in the sacroiliac joints is associated with the development of structural lesions at the same anatomical location over time in patients with axial spondyloarthritis.
- Source :
-
Seminars in arthritis and rheumatism [Semin Arthritis Rheum] 2023 Aug; Vol. 61, pp. 152225. Date of Electronic Publication: 2023 May 18. - Publication Year :
- 2023
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Abstract
- Objective: To assess whether the presence of bone marrow edema (BME) leads to the development of structural lesions at the same anatomical location of the sacroiliac joints (SIJ), and to investigate the association between BME patterns over time and structural lesions in patients with early axial spondyloarthritis (axSpA).<br />Methods: Patients with axSpA from the DESIR cohort with ≥2 consecutive magnetic resonance imaging (MRI)-SIJ were assessed at baseline, 2 and 5 years. MRI-SIJ images were divided into 8 quadrants. The association between BME and subsequent structural lesions (sclerosis, erosions, fatty lesions, and ankylosis) on MRI in the same quadrant was tested longitudinally. Additionally, patients were grouped according to the pattern of BME evolution across quadrants over time (no BME, sporadic, fluctuating, and persistent). The association between these patterns and 5-year imaging outcomes (eg: ≥5 erosions and/or fatty lesions on MRI-SIJ) was tested.<br />Results: In total, 196 patients were included. BME in each quadrant was associated with sclerosis (OR:1.9 (95%CI: 1.1;3.4)), erosions (1.9 (1.5;2.5)) and fatty lesions (1.9 (1.4;2.6)). Ankylosis was uncommon. There was a gradient between increased level of inflammation and subsequent damage: compared to the 'no BME' pattern, the sporadic (OR (95% CI): 2.1 (1.0;4.5)), fluctuating (OR:5.6(2.2;14.4)) and persistent (OR:7.5(2.8;19.6)) patterns were associated with higher structural damage on MRI-SIJ at 5-years.<br />Conclusions: In early axSpA, inflammation on MRI-SIJ leads to damage at the quadrant level. The higher the exposure to inflammation across quadrants in the SIJs over time the higher the likelihood of subsequent structural damage, suggesting a cumulative effect.<br />Competing Interests: Declaration of Competing Interest None declared.<br /> (Copyright © 2023. Published by Elsevier Inc.)
- Subjects :
- Humans
Sacroiliac Joint diagnostic imaging
Bone Marrow diagnostic imaging
Bone Marrow pathology
Sclerosis pathology
Inflammation
Magnetic Resonance Imaging methods
Edema diagnostic imaging
Edema pathology
Spondylarthritis complications
Spondylarthritis diagnostic imaging
Bone Marrow Diseases diagnostic imaging
Bone Marrow Diseases etiology
Axial Spondyloarthritis
Ankylosis pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-866X
- Volume :
- 61
- Database :
- MEDLINE
- Journal :
- Seminars in arthritis and rheumatism
- Publication Type :
- Academic Journal
- Accession number :
- 37263068
- Full Text :
- https://doi.org/10.1016/j.semarthrit.2023.152225