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AB0984 SACROILIAC MRI FINDINGS IN PATIENTS WHO WERE REQUESTED A SACROILIAC STUDY: SACROILIITIS AND OTHER DIAGNOSES

2023; BMJ; Linguagem: Inglês

10.1136/annrheumdis-2023-eular.2484

1468-2060

Raquel Almodóvar, A. Horcajadas, Pedro Zarco, Clementina López‐Medina, A. Benito Ysamat, J. F. Garcia Llorente, Fernando Díez Renovales, O. Casado Verdugo, Mireia Moreno, María Llop, Leire Berrocal, Ana Carmen Vela Marín, Cristina Fernández‐Carballido, C. Crespo, X. Juanola-Roura, José Antonio Narváez, E. Dieguez Costa, Ramón Mazzucchelli,

Osteomyelitis and Bone Disorders Research

Background Magnetic resonance imaging (MRI) is the most sensitive imaging modality for the detection of sacroiliitis. Diagnosing sacroiliitis on MRI is not always straightforward and can be challenging in some cases. Objectives To evaluate the prevalence of sacroiliitis (according to ASAS criteria) and other diagnoses in sacroiliac MRI. To analyse/compare these diagnoses by sex, age and service requesting the study. Methods This is a cross-sectional, multicentre, descriptive, retrospective study in a hospital and/or specialised care setting. Consecutive MRI examinations (in adults) of the sacroiliac joints (SIJ) performed between 1 de Enero de 2019 y el 31 de Diciembre del 2019 were retrospectively evaluated for the presence of structural and active sacroiliitis findings according to the Assessment of SpondyloArthritis International Society guidelines. Alternative diagnoses, including degenerative changes, diffuse idiopathic skeletal hyperostosis (DISH), osteitis condensans ilii (OCI), septic sacroiliitis/discitis, stress reaction and anatomic variants, were registered. Results We evaluated 1,283 MRI examinations, 526 (41%) males, average age 46.7 ± 14 years. 71.6% of the requests are from the Rheumatology service, 15.8% from Orthopedic Surgery and Traumatology and 12.5% from other services. 70% of the MRIs were reported by a radiologist expert in the locomotor system. Findings suggestive of axial spondyloarthritis were found in 353 (27.5%). Sacroiliitis was found in 71 examinations (25%) and alternative diagnoses were suggested in 87 (31%) (OCI 8.9%, anatomic variants 5.3%, septic sacroiliitis/discitis 5.3%, degenerative findings 4.3%, DISH 1.5%, stress reaction 0.7%, tumor 0.3%). A normal examination was found in the remaining 123 examinations. Patients with alternative diagnoses were older than those with sacroiliitis (62 vs. 47 years of age, respectively, P > 0.05). Alternative diagnoses in the SIJ were significantly more common in females (66) than in males (21), P < 0.05. Conclusion A substantial proportion of patients with suspected sacroiliitis had normal SIJ while the rest were more commonly diagnosed with pathologies other than inflammatory sacroiliitis. A referral by an experienced rheumatologist may improve the sensitivity and specificity of this important examination. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests None Declared.