title: Diagnostics of Sacroiliitis According to ASAS Criteria: A Comparative Evaluation of Conventional Radiographs and MRI in Patients with a Clinical Suspicion of Spondyloarthropathy. Preliminary Results.
abstract: BACKGROUND
  The objective of this study was a comparative evaluation of radiography and MRI in the diagnostics of sacroiliitis in patients with a clinical diagnosis of spondyloartropathy, according to the current ASAS criteria.
  
  
  METHODS
  Sacroiliac joints radiograms and MRI were conducted in 101 consecutive patients, aged 19-71 yrs (mean age: 40.6 yrs). The patients were referred by a senior rheumatologist, with symptoms of the chronic back pain. The sacroiliac joints were assessed on AP radiograms of the pelvis according to the modified New York criteria for ankylosing spondylitis. MRI was performed to look for active and chronic inflammatory lesions.
  
  
  RESULTS
  Of 14 patients with radiographic sacroiliitis according to modified New York criteria, only 50% had sacroiliitis on MRI. The sensitivity and specificity of conventional radiography were 22% and 94% and of MRI were 71% and 90%. Cohen's kappa coefficient was κ=0.0187, agreement of radiograms and MRI was 58%. Among 86 patients displaying no sacroiliitis on radiograms, MRI showed sacroiliitis in 34 patients (39.5%). Positive predictive value was 0.429, negative predictive value was 0.605.
  
  
  CONCLUSIONS
  MRI allowed to diagnose sacroiliitis in 39,5 % of patients in preradiographic stage. MRI ruled out the presence of active inflammatory lesions in 60.4% of patients with sacroiliitis on radiograms according to modified New York criteria.
authors.affiliation: Department of Radiology, Institute of Rheumatology, Warsaw, Poland ; Department of Diagnostic Imaging, Second Faculty, Warsaw Medical University, Warsaw, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Sudoł-Szopińska
authors.affiliation: Clinics of Early Arthritis, Institute of Rheumatology, Warsaw, Poland.
authors.forename: Brygida
authors.initials: B
authors.lastname: Kwiatkowska
authors.affiliation: Department of Radiology, Institute of Rheumatology, Warsaw, Poland ; Department of Diagnostic Imaging, Second Faculty, Warsaw Medical University, Warsaw, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Włodkowska-Korytkowska
authors.affiliation: Department of Radiology, Institute of Rheumatology, Warsaw, Poland.
authors.forename: Genowefa
authors.initials: G
authors.lastname: Matuszewska
authors.affiliation: Department of Radiology, Institute of Rheumatology, Warsaw, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Grochowska
keywords: Magnetic Resonance Imaging; Radiography; Sacroiliitis; Spondylarthropathies