Reflecting the perceived need for developing evidence-based recommendations on the use of imaging of the joints in the clinical management of spondyloarthritis (SpA) a European League Against Rheumatism (EULAR) convened a task force comprised of an expert group of 21 rheumatologists, radiologists and methodologists from 11 countries. The objectives of the task force were to formulate key clinical research questions relating to the role of imaging in both axial and peripheral SpA, to identify and critically appraise the available evidence, and to generate recommendations based on both evidence and expert opinion. Evaluated imaging modalities included conventional radiography, ultrasound, magnetic resonance imaging, computed-, positron emission- and single photon emission computed tomography, dual-emission x-ray absorptiometry and scintigraphy. Twelve research questions were generated using a process of discussion and consensus and a total of three systematic literature searches of articles were performed using MEDLINE and EMBASE databases. In addition the abstract archives of relevant international rheumatology and radiology meetings as well as the bibliographies of included papers were hand searched for evidence of other studies for inclusion. Titles and abstracts of all citations identified were screened, and potentially relevant articles were reviewed in full text using predetermined inclusion and exclusion criteria. A total of 7550 references were identified in the search process, from which 158 studies were finally included in the systematic reviews. Quality assessment of the included studies was performed using the QUADAS-2 tool. The results were presented to the taskforce members who then developed 10 recommendations, encompassing the full spectrum of imaging in making a diagnosis of axial or peripheral SpA, monitoring inflammation and damage, predicting outcome, response to treatment, and detecting spinal fractures and osteoporosis. The strength of each recommendation (SOR) was assessed by the taskforce members using a visual analogue scale and was generally very high (mean 8.9-9.5).
Disclosure of Interest None declared