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The influence of discrepant imaging judgements on the classification of axial spondyloarthritis is limited: a replication in the SpondyloArthritis Caught Early (SPACE) cohort
  1. Zineb Ez-Zaitouni1,
  2. Miranda van Lunteren1,
  3. Pauline A C Bakker1,
  4. Rosaline van den Berg1,
  5. Monique Reijnierse2,
  6. Karen Minde Fagerli3,
  7. Robert B M Landewé4,
  8. Roberta Ramonda5,
  9. Lennart T H Jacobsson6,
  10. Floris A van Gaalen1,
  11. Désirée van der Heijde1
  1. 1 Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
  3. 3 Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  4. 4 Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
  5. 5 Rheumatology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
  6. 6 Department of Rheumatology, University of Göteborg, Göteborg, Sweden
  1. Correspondence to Zineb Ez-Zaitouni, Department of Rheumatology, Leiden University Medical Center, PO Box 9600, Leiden 2300 RC, The Netherlands; z.ez-zaitouni{at}

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Sacroiliitis on imaging is important in the diagnosis and classification of patients with axial spondyloarthritis (axSpA). In the Assessment of SpondyloArthritis International Society (ASAS) classification criteria for axSpA, sacroiliitis is defined as either radiographic sacroiliitis (X-SI) according to the modified New York (mNY) criteria or active inflammation on MRI sacroiliac joints (MRI-SI) highly suggestive of axSpA (ASAS definition).1–4 According to the ASAS criteria, patients with chronic back pain are classified via the imaging arm when sacroiliitis on MRI-SI or X-SI plus ≥1 spondyloarthritis (SpA) feature is present, or via the clinical arm where ≥2 SpA features in addition to Human Leukocyte Antigen B27 (HLA-B27) have to be present.

While local clinicians can interpret imaging of the sacroiliac joints in the context of clinical information, central readers of research studies …

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  • Contributors All authors contributed to the study design and interpretation of data. ZEZ was responsible for the statistical analysis and prepared the first version of the manuscript. All authors approved the final version of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The study has been approved by the local medical ethics committees. All patients provided written informed consent.

  • Provenance and peer review Not commissioned; internally peer reviewed.