title: EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice.
abstract: A taskforce comprised of an expert group of 21 rheumatologists, radiologists and methodologists from 11 countries developed evidence-based recommendations on the use of imaging in the clinical management of both axial and peripheral spondyloarthritis (SpA). Twelve key questions on the role of imaging in SpA were generated using a process of discussion and consensus. Imaging modalities included conventional radiography, ultrasound, magnetic resonance imaging, computed tomography (CT), positron emission tomography, single photon emission CT, dual-emission x-ray absorptiometry and scintigraphy. Experts applied research evidence obtained from systematic literature reviews using MEDLINE and EMBASE to develop a set of 10 recommendations. The strength of recommendations (SOR) was assessed by taskforce members using a visual analogue scale. A total of 7550 references were identified in the search process, from which 158 studies were included in the systematic review. Ten recommendations were produced using research-based evidence and expert opinion encompassing the role of imaging in making a diagnosis of axial SpA or peripheral SpA, monitoring inflammation and damage, predicting outcome, response to treatment, and detecting spinal fractures and osteoporosis. The SOR for each recommendation was generally very high (range 8.9-9.5). These are the first recommendations which encompass the entire spectrum of SpA and evaluate the full role of all commonly used imaging modalities. We aimed to produce recommendations that are practical and valuable in daily practice for rheumatologists, radiologists and general practitioners.
authors.affiliation: Division of Rheumatology, Medical University of Vienna, Vienna, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Mandl
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands University Hospital La Paz, Madrid, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Navarro-Compán
authors.affiliation: Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital at Glostrup, Copenhagen, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Terslev
authors.affiliation: Public Health Department, Ambroise Paré Hospital, Boulogne-Billancourt, France.
authors.forename: P
authors.initials: P
authors.lastname: Aegerter
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: D
authors.identifier: http://orcid.org/0000-0002-5781-158X
authors.initials: D
authors.lastname: van der Heijde
authors.affiliation: Department of Rheumatology, Ambroise Paré Hospital, Boulogne-Billancourt, France.
authors.forename: M A
authors.initials: MA
authors.lastname: D'Agostino
authors.affiliation: Rheumazentrum Ruhrgebiet, Herne, Germany.
authors.forename: X
authors.initials: X
authors.lastname: Baraliakos
authors.affiliation: Department of Rheumatology, Copenhagen University Hospital at Gentofte, Copenhagen, Denmark.
authors.forename: S J
authors.initials: SJ
authors.lastname: Pedersen
authors.affiliation: Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: A G
authors.initials: AG
authors.lastname: Jurik
authors.affiliation: Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Naredo
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Schueller-Weidekamm
authors.affiliation: King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark.
authors.forename: U
authors.initials: U
authors.lastname: Weber
authors.affiliation: Department of Radiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: M C
authors.initials: MC
authors.lastname: Wick
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: P A C
authors.initials: PA
authors.lastname: Bakker
authors.affiliation: Department of Rheumatology, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Filippucci
authors.affiliation: NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
authors.forename: P G
authors.initials: PG
authors.lastname: Conaghan
authors.affiliation: Department of Rheumatology, Charité Universitätsmedizin, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Rudwaleit
authors.affiliation: Department of Rheumatology and Immunology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Schett
authors.affiliation: Department of Rheumatology, Charité Universitätsmedizin, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Sieper
authors.affiliation: Musculoskeletal Statistics Unit, Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Tarp
authors.affiliation: NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
authors.forename: H
authors.initials: H
authors.lastname: Marzo-Ortega
authors.affiliation: Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital at Glostrup, Copenhagen, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Østergaard
mesh_terms: D003952:Diagnostic Imaging / Q000379:methods*; D005060:Europe; D006801:Humans; D008279:Magnetic Resonance Imaging; D049268:Positron-Emission Tomography; D011859:Radiography; D025241:Spondylarthritis / Q000145:classification / Q000175:diagnosis* / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: Magnetic Resonance Imaging; Psoriatic Arthritis; Reactive arthritis; Spondyloarthritis; Ultrasonography