Correlation between MRI sacroiliitis grades based on SPARCC and Romanus lesion with BASDAI scores, ASDAS-CRP, and ASDAS-ESR: a study of ankylosing spondylitis

Abstract Background Ankylosing spondylitis (AS) is a form of autoimmune spondyloarthritis that primarily affects the axial skeleton, including the spinal and sacroiliac joints. Magnetic resonance imaging (MRI), including assessment using the Spondyloarthritis Research Consortium of Canada (SPARCC) score and the identification of Romanus lesions, can provide information regarding imaging findings in AS. However, their association with clinical disease activity indices such as BASDAI, ASDAS-CRP, and ASDAS-ESR has been scarcely investigated in Indonesia. Aim This study aimed to analyze the association between MRI sacroiliitis severity based on the SPARCC score and Romanus lesions with BASDAI, ASDAS-CRP, and ASDAS-ESR scores in patients with ankylosing spondylitis. Method This observational analytic study with a cross-sectional design included 48 patients with ankylosing spondylitis who underwent non-contrast MRI of the sacroiliac joints and spine and met the study criteria. Sacroiliitis severity was assessed using the SPARCC score, while Romanus lesions were assessed based on their presence or absence on MRI. Their associations with BASDAI, ASDAS-CRP, and ASDAS-ESR scores were analyzed using Spearman’s rank correlation and the Mann–Whitney U-test, as appropriate. Results The SPARCC score showed a strong positive correlation with BASDAI (rho = 0.856; p < 0.001) and moderate positive correlations with ASDAS-CRP (rho = 0.622; p < 0.001) and ASDAS-ESR (rho = 0.662; p < 0.001). No significant differences in BASDAI, ASDAS-CRP, or ASDAS-ESR scores were observed between subjects with and without Romanus lesions ( p = 0.193, p = 0.081, and p = 0.228, respectively). In this cross-sectional study, higher SPARCC scores were associated with higher clinical disease activity scores. However, the cross-sectional design does not allow conclusions regarding the temporal relationship or causality between MRI findings and clinical disease activity. Romanus lesions were not significantly associated with BASDAI, ASDAS-CRP, or ASDAS-ESR scores.