HLA-B27 and gender independently determine the likelihood of a positive MRI of the sacroiliac joints in patients with early inflammatory back pain: a 2-year MRI follow-up study.

Abstract

OBJECTIVES:

To describe how inflammation on MRI of the sacroiliac joints in patients with recent-onset inflammatory back pain (IBP) evolves over time, and to study determinants of activity on MRI of the sacroiliac joint.

METHODS:

A 2-year follow-up study with annual MRI of the sacroiliac joints was conducted in patients with IBP of less than 2 years' duration. Images were scored for bone marrow oedema on short τ inversion recovery and enhancement after administration of gadolinium on T1.

RESULTS:

Of the 68 patients (38% male; mean age 34.9 ± 10.3 years) enrolled, 44 had a negative baseline MRI. Of these 44 patients, 39 patients had at least one follow-up MRI of whom six patients (15%) developed activity on MRI during follow-up. 24 patients (35%) had an abnormal MRI at baseline. In 23 of these 24 patients follow-up MRI was available. The MRI became negative in seven of these 23 patients (30%) during follow-up. Human leucocyte antigen B27 (HLA-B27) positivity and male gender determined independently the likelihood of a positive MRI at any time point. In an HLA-B27-positive patient the likelihood of a positive MRI during follow-up is 88% if the baseline MRI is positive and 27% if the baseline MRI is negative. In an HLA-B27-negative patient with a negative MRI at baseline the likelihood of a positive MRI during follow-up is less than 5%.

CONCLUSIONS:

A positive MRI at baseline predicts a positive MRI during follow-up in HLA-B27-positive patients. A negative MRI at baseline in HLA-B27-negative patients strongly predicts a negative MRI during follow-up.

• Authors: M van Onna, A G Jurik, D van der Heijde, A van Tubergen, L Heuft-Dorenbosch, R Landewé
• Journal: Annals of the rheumatic diseases (Ann Rheum Dis) Vol. 70 Issue 11 Pg. 1981-5 (Nov 2011) ISSN: 1468-2060 [Electronic] England
• PMID: 21859694 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• HLA-B27 Antigen

Topics

• Adult
• Biomarkers (analysis)
• Disease Progression
• Female
• Follow-Up Studies
• HLA-B27 Antigen (analysis)
• Humans
• Low Back Pain (etiology)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Prognosis
• Risk Factors
• Sacroiliac Joint (pathology)
• Sacroiliitis (complications, diagnosis)
• Sex Factors
• Spondylarthritis (complications, diagnosis)
• Young Adult