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The diagnostic value of scintigraphy in assessing sacroiliitis in Ankylosing Spondylitis - a systematic literature research
  1. IH Song (in-ho.song{at}charite.de)
  1. Charité Rheumatology, Med. Clinic I, Berlin, Germany, Germany
    1. J Carrasco-Fernández (josecarrasco_reuma{at}yahoo.es)
    1. Rheumatology, Universitary Hospital “Reina Sofía”, Córdoba, Spain, Spain
      1. M Rudwaleit (martin.rudwaleit{at}charite.de)
      1. Charité Rheumatology, Med. Clinic I, Berlin, Germany, Germany
        1. J Sieper (joachim.sieper{at}charite.de)
        1. Charité Rheumatology, Med. Clinic I, Berlin, Germany, Germany

          Abstract

          Background: The diagnostic value of scintigraphy in detecting sacroiliitis in patients with spondyloarthritis is not clear.

          Objective: To assess the diagnostic value of scintigraphy in detecting sacroiliitis in ankylosing spondylitis (AS) and in patients with clinically probable sacroiliitis without x-ray changes. Material and methods: A systematic literature research was performed in the pubmed and medline database up to August 2007. Articles in English and German on patients with established AS and clinically probable sacroiliitis without x-ray changes were selected. In addition, studies including patients with mechanical low back pain (MLBP) as a control group were searched. Pooled sensitivity, specificity and positive and negative likelihood ratios (LRs) were calculated.

          Results: In total 99 articles about scintigraphy were found. 25 articles were included into the analysis. Overall sensitivity for scintigraphy to detect sacroiliitis was 51.8% for patients with established AS (N= 361) and 49.4% for patients with probable sacroiliitis (N= 255). Sensitivity of scintigraphy in AS patients with inflammatory back pain (indicating ongoing inflammation) was 52.7% (N= 112) and in patients with AS and suspected sacroiliitis with magnetic resonance imaging showing acute sacroiliitis (as a gold standard) was 53.2% (N= 62). In controls with MLBP specificity was 78.3% (N= 60) resulting in LRs not higher than 2.5-3.0.

          Conclusion: These data as a result of a literature research suggest that scintigraphy of the sacroiliac joints is at the most of limited diagnostic value for the diagnosis of established AS including the early diagnosis of probable / suspected sacroiliitis.

          • ankylosing spondylitis
          • diagnosis
          • sacroiliitis
          • scintigraphy
          • sensitivity

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