Imaging for the diagnosis and follow-up of ankylosing spondylitis: development of recommendations for clinical practice based on published evidence and expert opinion.
OBJECTIVE
To develop recommendations regarding imaging studies for the diagnosis and follow-up of patients with axial forms of ankylosing spondylitis (AS) seen in everyday practice.


METHODS
Evidence from the literature and expert opinion were used to develop the recommendations. Using the Delphi consensus procedure, a scientific committee selected five areas of interest, about which scientific evidence was sought by searching Medline and the databases maintained by the French Society for Rheumatology, European League against Rheumatism, and American College of Rheumatology. Based on this evidence, a panel of experienced rheumatologists drafted recommendations, using expert opinion if needed to supplement gaps in evidence. For each recommendation, the level of evidence and the extent of agreement among the experts were specified.


RESULTS
The five areas of interest dealt with the usefulness of imaging studies for the diagnosis, follow-up, prognostic evaluation, and assessment of treatment responses in patients with AS. The literature search retrieved 144 articles based on titles and abstracts. After elimination of articles that did not include an analysis of the radiological evaluation of AS, 73 articles were left for review. Eight recommendations were drafted then validated by having all panel participants vote during a final meeting.


CONCLUSIONS
Eight recommendations about the use of imaging studies in patients with AS were developed. They can be expected to improve clinical practice uniformity and, in the longer term, to optimize the management of patients with AS.
Pavy
Stephan
S
Service de Médecine Interne 1, CHU Pitié-Salpêtrière, Paris, France.
Dernis
Emmanuelle
E
Lavie
Frédéric
F
Maillefert
Jean-Francis
JF
Mariette
Xavier
X
Schaeverbeke
Thierry
T
Cantagrel
Alain
A
Claudepierre
Pascal
P
Flipo
René-Marc
RM
Goupille
Philippe
P
Le Loet
Xavier
X
Saraux
Alain
A
Tebib
Jacques
J
Wendling
Daniel
D
Combe
Bernard
B
D003266:Continuity of Patient Care; D003697:Delphi Technique; D003952:Diagnostic Imaging / Q000379:methods*; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D013167:Spondylitis, Ankylosing / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed / Q000379:methods