title: Degree of bone marrow oedema in sacroiliac joints of patients with axial spondyloarthritis is linked to gut inflammation and male sex: results from the GIANT cohort.
abstract: BACKGROUND
  Bone marrow oedema (BMO) of the sacroiliac joints (SIJs) is a hallmark of axial spondyloarthritis (SpA). However, the relationship between the extent of BMO and disease phenotype is poorly understood.
  
  
  OBJECTIVE
  To assess the link between BMO of the SIJs and gut inflammation. We have also evaluated the correlation between BMO and established disease activity parameters.
  
  
  METHODS
  Sixty-eight patients with axial SpA from the Gent Inflammatory Arthritis and spoNdylitis cohorT underwent ileocolonoscopy and MRI of the SIJs. Histopathological analysis and SPondyloArthritis Research Consortium of Canada (SPARCC) scores were performed.
  
  
  RESULTS
  A significant higher SPARCC score (median (range)) was observed in axial SpA patients showing chronic gut inflammation (16.9 (3.8-68.3)) compared with axial SpA patients showing normal gut histology (9.8 (0.0-45.0); p<0.05). In a multiple linear regression model, we identified, besides chronic gut inflammation (effect size of 11.3, 95% CI (2.1 to 20.4)), male sex (effect size of 10.5, 95% CI (3.3 to 17.8)) to be independently associated to the extent of BMO. There was a low to moderate correlation between the degree of BMO and C-reactive protein(r=0.39, p=0.002) and Ankylosing Spondylitis Disease Activity Score (r=0.35, p=0.007).
  
  
  CONCLUSIONS
  Higher degrees of BMO were observed in patients showing chronic gut inflammation. These data solidify a link between mucosal inflammation and progressive disease in axial SpA.
authors.affiliation: Department of Rheumatology, Ghent University Hospital, , Ghent, Belgium.
authors.forename: Liesbet
authors.initials: L
authors.lastname: Van Praet
authors.forename: Lennart
authors.initials: L
authors.lastname: Jans
authors.forename: Philippe
authors.initials: P
authors.lastname: Carron
authors.forename: Peggy
authors.initials: P
authors.lastname: Jacques
authors.forename: Elien
authors.initials: E
authors.lastname: Glorieus
authors.forename: Roos
authors.initials: R
authors.lastname: Colman
authors.forename: Heleen
authors.initials: H
authors.lastname: Cypers
authors.forename: Herman
authors.initials: H
authors.lastname: Mielants
authors.forename: Martine
authors.initials: M
authors.lastname: De Vos
authors.forename: Claude
authors.initials: C
authors.lastname: Cuvelier
authors.forename: Filip
authors.initials: F
authors.lastname: Van den Bosch
authors.forename: Dirk
authors.initials: D
authors.lastname: Elewaut
mesh_terms: D000328:Adult; D001855:Bone Marrow Diseases / Q000150:complications / Q000473:pathology*; D015331:Cohort Studies; D003092:Colitis / Q000150:complications / Q000473:pathology*; D003113:Colonoscopy; D004487:Edema / Q000150:complications / Q000473:pathology*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007079:Ileitis / Q000150:complications / Q000473:pathology*; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010641:Phenotype; D011446:Prospective Studies; D012446:Sacroiliac Joint / Q000473:pathology*; D012737:Sex Factors; D025241:Spondylarthritis / Q000150:complications / Q000473:pathology*; D055815:Young Adult
keywords: Inflammation; Magnetic Resonance Imaging; Spondyloarthritis