Progression of sacroiliac joint structural lesions in axial spondyloarthritis: a longitudinal comparative study of MRI and radiography among European patients in routine clinical care

Abstract Background To compare the performances of magnetic resonance imaging (MRI) and radiography in detecting changes in structural lesions of the sacroiliac joints (SIJs) in routine care patients with axial spondyloarthritis (axSpA). Methods SIJ MRIs and radiographs of routine care patients with axSpA in four European countries were collected as part of the EuroSpA Imaging Project. Patients were included if both MRIs and radiographs (≤ 6 months apart) were available at two time points (≥ 1 year apart). Images were evaluated centrally and independently by two trained readers (blinded to chronology and other imaging), applying the Spondyloarthritis Research Consortium of Canada SIJ scores (MRI) and the modified New York criteria (mNY, radiography). Intermodality agreement was assessed cross-sectionally and for change. Results One-hundred-and-five patients (65 male, mean (SD) age 38.1 (10.9) years, symptom duration 9.1 (9.7) years), with a follow-up interval of 2.6 (1.4) years) were included. Baseline agreement between radiography and MRI was slight-to-fair for erosion detection (kappa = 0.12 to 0.42), poor to slight for sclerosis (− 0.04 to 0.07), and substantial to almost perfect for ankylosis (0.66–0.86). Agreement for change over time was poor-to-slight (− 0.04 to 0.20). While lesions remained largely stable on radiography (≤ 6 patients showing change in scores, per lesion type), MRI detected change in at least one lesion in ≥ 50% of patients (positive/negative change in scores (“progression”/”regression”): sclerosis 27/30, erosion 51/38, ankylosis 14/5). A composite MRI score of damage correlated well with mNY grades (Spearman rho = 0.65–0.69). Conclusions Compared to radiography, MRI detected more SIJ structural lesion changes over time, reflecting its ability to capture dynamic changes not readily visible on radiography.

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Journal
Arthritis Research & Therapy
Published
2026-10-13
DOI
https://doi.org/10.1186/s13075-026-03921-8
Primary Topic
Spondyloarthritis Studies and Treatments
Type
article
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article

Progression of sacroiliac joint structural lesions in axial spondyloarthritis: a longitudinal comparative study of MRI and radiography among European patients in routine clinical care

Simon Krabbe, Torsten Diekhoff, Adrian Ciurea, Kasper Kjaerulf Gosvig et al.
Arthritis Research & Therapy
Spondyloarthritis Studies and Treatments
article

Progression of sacroiliac joint structural lesions in axial spondyloarthritis: a longitudinal comparative study of MRI and radiography among European patients in routine clinical care

Simon Krabbe, Torsten Diekhoff, Adrian Ciurea, Kasper Kjaerulf Gosvig, Jakub Závada, Manouk de Hooge, Susanne Juhl Pedersen, Raphael Micheroli, Stephanie A. Wichuk, Michael John Nissen, Iwona Sudoł‐Szopińska, Lykke Midtbøll Ørnbjerg, Nora Vladimirova, Karlo Pintarić, Iris Eshed, Monika Gregová, Björn Guðbjörnsson, Merete Lund Hetland, Mikkel Østergaard, Kristýna Bubová, Žiga Snoj, Robert George William Lambert, Marie Wetterslev, A. E. F. Hadsbjerg, Burkhard Möller, Jakob Møllenbach Møller, Žiga Rotar, Alexander Bernatschek, Maurice Donzallaz, Annik Steimer, Jonas Brändli, Claudia Lourenço Rodrigues
article en

Abstract

Abstract Background To compare the performances of magnetic resonance imaging (MRI) and radiography in detecting changes in structural lesions of the sacroiliac joints (SIJs) in routine care patients with axial spondyloarthritis (axSpA). Methods SIJ MRIs and radiographs of routine care patients with axSpA in four European countries were collected as part of the EuroSpA Imaging Project. Patients were included if both MRIs and radiographs (≤ 6 months apart) were available at two time points (≥ 1 year apart). Images were evaluated centrally and independently by two trained readers (blinded to chronology and other imaging), applying the Spondyloarthritis Research Consortium of Canada SIJ scores (MRI) and the modified New York criteria (mNY, radiography). Intermodality agreement was assessed cross-sectionally and for change. Results One-hundred-and-five patients (65 male, mean (SD) age 38.1 (10.9) years, symptom duration 9.1 (9.7) years), with a follow-up interval of 2.6 (1.4) years) were included. Baseline agreement between radiography and MRI was slight-to-fair for erosion detection (kappa = 0.12 to 0.42), poor to slight for sclerosis (− 0.04 to 0.07), and substantial to almost perfect for ankylosis (0.66–0.86). Agreement for change over time was poor-to-slight (− 0.04 to 0.20). While lesions remained largely stable on radiography (≤ 6 patients showing change in scores, per lesion type), MRI detected change in at least one lesion in ≥ 50% of patients (positive/negative change in scores (“progression”/”regression”): sclerosis 27/30, erosion 51/38, ankylosis 14/5). A composite MRI score of damage correlated well with mNY grades (Spearman rho = 0.65–0.69). Conclusions Compared to radiography, MRI detected more SIJ structural lesion changes over time, reflecting its ability to capture dynamic changes not readily visible on radiography.

Arthritis Research & Therapy
University of Copenhagen (DK), University of Ljubljana (SI), University of Alberta (CA), University of Iceland (IS), University of Zurich (CH), Charles University (CZ), Sheba Medical Center (IL), University Hospital of Bern (CH), Ljubljana University Medical Centre (SI), Herlev Hospital (DK), Glostrup Hospital (DK), Copenhagen University Hospital (DK), Gentofte Hospital (DK), Rigshospitalet (DK), Ghent University (BE), Institute of Rheumatology (CZ), University Hospital of Zurich (CH), University Hospital of Geneva (CH), National University Hospital of Iceland (IS), National Institute of Geriatrics, Rheumatology and Rehabilitation (PL), SCQM Foundation (CH)
Openalex Percentile: Top 12%
Spondyloarthritis Studies and Treatments
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