TY - JOUR T1 - The yield of a positive MRI of the spine as imaging criterion in the ASAS classification criteria for axial spondyloarthritis: results from the SPACE and DESIR cohorts JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 1731 LP - 1736 DO - 10.1136/annrheumdis-2017-211486 VL - 76 IS - 10 AU - Zineb Ez-Zaitouni AU - Pauline AC Bakker AU - Miranda van Lunteren AU - Manouk de Hooge AU - Rosaline van den Berg AU - Monique Reijnierse AU - Karen Minde Fagerli AU - Robert BM Landewé AU - Roberta Ramonda AU - Lennart TH Jacobsson AU - Alain Saraux AU - Gregory Lenczner AU - Antoine Feydy AU - Jean Baptiste Pialat AU - Fabrice Thévenin AU - Floris A van Gaalen AU - Désirée van der Heijde Y1 - 2017/10/01 UR - http://ard.bmj.com/content/76/10/1731.abstract N2 - Objectives To assess the prevalence of spinal inflammation on MRI in patients with chronic back pain (CBP) of maximally 3 years duration and to evaluate the yield of adding a positive MRI-spine as imaging criterion to the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial spondyloarthritis (axSpA).Methods Baseline imaging of the sacroiliac joints (X-SI), MRI of the sacroiliac joints (MRI-SI) and MRI-spine were scored by ≥2 experienced central readers per modality in the SPondyloArthritis Caught Early (SPACE) and DEvenir des Spondylarthropathies Indifférenciées Récentes (DESIR) cohorts. Inflammation suggestive of axSpA was assessed in the entire spine. A positive MRI-spine was defined by the presence of ≥5 inflammatory lesions. Alternative less strict definitions were also tested.Results In this study, 541 and 650 patients with CBP from the SPACE and DESIR cohorts were included. Sacroiliitis on X-SI and MRI-SI was found in 40/541 (7%) and 76/541 (14%) patients in SPACE, and in DESIR in 134/650 (21%) and 231/650 (36%) patients, respectively. In SPACE and DESIR, a positive MRI-spine was seen in 4/541 (1%) and 48/650 (7%) patients. Of the patients without sacroiliitis on imaging, 3/447 (1%) (SPACE) and 8/382 (2%) (DESIR) patients had a positive MRI-spine. Adding positive MRI-spine as imaging criterion led to new classification in only one patient in each cohort, as the other patients already fulfilled the clinical arm. Other definitions of a positive MRI-spine yielded similar results.Conclusion In two cohorts of patients with CBP with a maximum symptom duration of 3 years, a positive MRI-spine was rare in patients without sacroiliitis on MRI-SI and X-SI. Addition of MRI-spine as imaging criterion to the ASAS axSpA criteria had a low yield of newly classified patients and is therefore not recommended. ER -