Background On MRI, patients with axial spondyloarthritis (axSpA) demonstrate lesions at several anatomical locations. These locations include the vertebral bodies, e.g. anterior and posterior corners and lesions without relation to the corners, and also the posterior segments of the vertebrae, e.g. the costo-transversal joints, costo-vertebral joints, facet joints, spinous/transverse processes, and surrounding soft tissue. The Canada-Denmark (CanDen) definitions of MRI lesions in the spine allows a detailed evaluation of all these anatomical locations for inflammation, fat, erosions and new bone formation.(1–3)
Objectives To assess the anatomical location of positive scores by the CanDen MRI scoring system of the spine.
Methods 49 patients with axial SpA (ASAS criteria) and clinical indication for tumor necrosis factor alpha (TNFα) inhibitor, including BASDAI >40 mm, had MRI of the spine performed at baseline. 51% were male. Median symptom duration (range) was 12 (0–45) years. Images were scored using the CANDEN MRI scoring system by a reader blinded to clinical data.
ResultsIn total, 10 of 49 patients (20%) had involvement of the costo-transversal joints, facet joints, spinous/transverse processes or soft tissue.
Conclusions The most frequent lesion in patients with axSpA were inflammation and fat lesions in the rim of the vertebral bodies (the anterior, posterior, antero-lateral and postero-lateral corner lesions) in the thoracic and lumbar spine. 1/5 of the patients had involvement of the posterior segments.
Østergaard et al. J Rheumatol 2009;36-S84:18–34
Lambert et al. J Rheumatol 2009;36-S84:3–17
Pedersen et al. J Rheumatol 2009;36-S84:35–38
Chiowchanwisawakit et al. J Rheumatol 2009;36-S84:39–47
Disclosure of Interest None declared