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Determining the presence of radiographic sacroiliitis is a key feature in the diagnostic process of radiographic axial spondyloarthritis (r-axSpA), synonymous to ankylosing spondylitis according to the modified New York criteria (mNY).1 Its presence is considered prognostically relevant and paves the way for treatment with biological drugs.2 Multiread and multireader exercises have proven that radiographic sacroiliitis is an ambiguous finding, as reflected by large inter-reader and intrareader variability.3 ,4
Determining progression of radiographic sacroiliitis, which marks the arbitrary but irreversible change from non-radiographic axSpA (nr-axSpA) to r-axSpA, is even more ambiguous. The mNY lack sensitivity-to-change in this slowly progressing condition, and it is conceivable that regression of radiographic sacroiliitis is very rare if not impossible.5 Previous studies addressing progression from nr-axSpA to …
Contributors All authors contributed to the study design and interpretation of data. AS was responsible for the statistical analysis and prepared the first version of the manuscript. All authors approved the final version of the manuscript.
Funding This study was financially supported by ASAS. AS received a research grant from ASAS for a fellowship, during which the study analysis was performed.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The study has been approved by the local ethics committees. All patients provided written informed consent at the baseline visit that also included consent for the follow-up visit.
Provenance and peer review Not commissioned; externally peer reviewed.