New guidance for the use of MRI in Axial spondyloarthritis will improve diagnostic accuracy

The first UK recommendations designed to help clinicians make the best use of MRI in the diagnosis of Axial spondyloarthritis (Axial SpA) were published in Rheumatology by an expert task force of rheumatologists and radiologists assembled by the British Society for Spondyloarthritis (BRITSpA).

Researchers recognised the heterogeneity around MRI protocols and image interpretation across the UK and how this is contributing to inconsistency and delay in diagnosis of Axial SpA.

Axial SpA mainly affects the spine and sacroiliac joints but can also affect other joints, tendons and ligaments. Inflammation can occur at the site where ligaments or tendons attach to the bone; as the inflammation reduces healing takes place and new bone develops. Movement becomes restricted when bone replaces the elastic tissue of ligaments or tendons.

Repetition of this inflammatory process leads to further new bone formation and the individual bones that make up the backbone can fuse together.

One in 200 of the adult population in the UK have Axial SpA – twice as many as multiple sclerosis and Parkinson’s disease – and it affects young people with symptoms starting to occur in late teens to early twenties.

Supported by a summary of scientific research, the researchers were able to achieve a joint consensus on the acquisition and interpretation of MRI in Axial SpA which could lead to early and more accurate diagnosis.

Lead author Dr Pedro Machado, principal investigator at the Centre for Rheumatology, UCL Division of Medicine, and at the Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, said this consensus will help standardise and decrease heterogeneity around the use of MRI in patients.

“These recommendations can be immediately applied to clinical practice and they can contribute to the early diagnosis of Axial SpA and to the achievement of better health outcomes by these patients,” said Dr Machado.

“It will also help ensure a more informed and consistent approach to the diagnosis of Axial SpA and contribute to a more appropriate and cost-effective utilisation of MRI in clinical practice, and therefore more efficient health care resource utilisation.”  

President of the British Society for Spondyloarthritis (BRITSpA) and co-author, Dr Helena Marzo-Ortega said: “This is an excellent example of collaborative work between rheumatologists and radiologists to improve and standardise care for people affected by Axial SpA across the UK.”

Dr Machado said the next step is to disseminate these recommendations more widely with the support of the British Society Spondyloarthritis, in order to make sure they are applied in clinical practice.

Links

• Dr Pedro Machado 
• UCL Queen Square Institute of Neurology 
• UCL Division of Medicine 
• British Society of Spondyloarthritis 
• British Society for Rheumatology 
• Rheumatology Article