Journal Information
Vol. 20. Issue 4.
Pages 187-192 (April 2024)
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Vol. 20. Issue 4.
Pages 187-192 (April 2024)
Original Article
Does sacroiliitis is a mandatory criterion for enthesitis-related arthritis diagnosis?
¿La sacroilitis es un criterio obligatorio para el diagnóstico de artritis relacionada con entesitis?
Hanene Lassoued Ferjania,b,c, Lobna Kharrata,b,
Corresponding author
kharratlobna1992@gmail.com

Corresponding author.
, Dorra Ben Nessiba,b,c, Dhia Kaffela,b,c, Kaouther Maatallaha,b,c, Wafa Hamdia,b,c
a Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia
b Faculty of Medicine of Tunis, University Tunis el Manar, Tunisia
c Research Unit UR17SP04, Ksar Saïd, 2010 Tunis, Tunisia
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Tables (4)
Table 1. Characteristics of the population studied.
Table 2. Comparison between ERA patients and non-ERA patients’ characteristics.
Table 3. Association between sacroiliac joints MRI lesions and JIA characteristics.
Table 4. Sensitivity, specificity, positive predictive value, and negative predictive of the sacroiliac joints. Magnetic resonance imaging lesions (bone marrow edema and/or erosions) in the diagnosis of enthesitis-related arthritis.
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Abstract
Introduction and objectives

Magnetic resonance imaging (MRI) sensitivity and specificity seem to be less studied in enthesitis-related arthritis (ERA).

We aimed to determine the ability of sacroiliac MRI to diagnose ERA patients.

Materials and methods

We conducted a retrospective study including 44 patients with juvenile idiopathic arthritis (JIA). Each patient had a sacroiliac joint MRI. We divided patients into two groups: G1 patients with ERA and G2 patients with non-ERA subtype.

Results

ERA was noted in 61% of the cases. Sacroiliac joints were painful in 15 patients (34%). MRI was normal in 25 patients (57%) (G1:11 versus G2:14) and showed bone marrow edema in the sacroiliac joints in 19 patients (34%) (G1=16 versus G2=3, p=0.005).

Sacroiliac joints MRI's sensitivity and specificity in the ERA diagnosis were 61.54% and 82.35%, respectively. Positive and negative predictive values were 84.21% and 58.33%, respectively. Furthermore, sacroiliac joint pain in the clinical examination was able to predict sacroiliac bone edema in MRI with an odds ratio of 6.8 (95% CI 1.68–28.09; p=0.006).

Conclusion

Our study showed that sacroiliac joint MRI has good specificity and positive predictive value in the diagnosis of ERA patients among JIA patients. This underlines the usefulness of sacroiliac joint MRI in the early diagnosis of ERA patients.

Keywords:
Enthesitis-related arthritis
Juvenile idiopathic arthritis
Juvenile spondyloarthritis
Magnetic resonance imaging
Sacroiliitis
Resumen
Introducción y objetivos

La sensibilidad y especificidad de la resonancia magnética parecen estar menos estudiadas en la artritis relacionada con entesitis (ERA).

Nuestro objetivo era determinar la capacidad de la resonancia magnética de la articulación sacroilíaca para diagnosticar pacientes con ERA.

Materiales y métodos

Realizamos un estudio retrospectivo que incluyó a 44 pacientes con artritis idiopática juvenil (AIJ). A cada paciente se le realizó una resonancia magnética de la articulación sacroilíaca. Dividimos a los pacientes en dos grupos: G1: pacientes con ERA y G2: pacientes con subtipo no ERA.

Resultados

Se observó ERA en 61% de los casos. Las articulaciones sacroilíacas resultaron dolorosas en 15 pacientes (34%). La resonancia magnética fue normal en 25 pacientes (57%) (G1:11 vs. G2:14) y mostró edema de médula ósea en las articulaciones sacroilíacas en 19 pacientes (34%) (G1=16 vs. G2=3, p=0,005).

La sensibilidad y especificidad de la resonancia magnética de articulaciones sacroilíacas en el diagnóstico de ERA fueron de 61,54 y 82,35%, respectivamente. Los valores predictivos positivos y negativos fueron 84,21 y 58,33%, respectivamente. Además, el dolor en la articulación sacroilíaca en el examen clínico fue capaz de predecir el edema del hueso sacroilíaco en la resonancia magnética con un odds ratio de 6,8 (IC 95%: 1,68 a 28,09; p=0,006).

Conclusión

Nuestro estudio demostró que la resonancia magnética de la articulación sacroilíaca tiene buena especificidad y valor predictivo positivo en el diagnóstico de pacientes con ERA entre pacientes con AIJ. Esto subraya la utilidad de la resonancia magnética de la articulación sacroilíaca en el diagnóstico temprano de pacientes con ERA.

Palabras clave:
Artritis relacionada con entesitis
Artritis idiopática juvenil
Espondiloartritis juvenil
Resonancia magnética
Sacroilitis

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