Active inflammatory changes around the pubic symphysis in patients with axial spondyloarthritis: Magnetic resonance imaging characteristics and association with clinical factors. Issue 124 (March 2020)

• Record Type: Journal Article
• Authors: Kang, Yusuhn; Ahn, Joong Mo; Lee, Eugene; Lee, Joon Woo; Kang, Heung Sik
• Is Part Of: European journal of radiology. Issue 124(2020)
• Publication Date: 2020-03
• Subjects: SpA spondyloarthritis -- HLA human leukocyte antigen -- MRI magnetic resonance imaging -- STIR short-tau inversion recovery -- ASAS Assessment of the SpondyloArthritis International Society; Magnetic resonance imaging -- Axial spondyloarthritis -- Symphysis pubis -- Ankylosing spondylitis; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2019.108802
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Active inflammatory change of pubic symphysis is a feature of spondyloarthritis. Active inflammatory change of pubic symphysis is associated with older age. Acute phase proteins are elevated in patients with pubic symphysis changes. Abstract: Purpose: To determine the prevalence of active inflammatory changes around the pubic symphysis on MRI scans in patients with axial spondyloarthritis, and to evaluate its association with clinical factors. Method: A retrospective analysis of MRI scans of 128 patients clinically diagnosed with axial spondyloarthritis was performed to assess the presence of active inflammatory changes around the pubic symphysis (bone marrow edema/osteitis and enthesitis). The clinical factors of the patients with and without active inflammatory changes around the pubic symphysis were compared. Results: MRI scans showed active inflammatory changes around the pubic symphysis in 23 patients (18.0 %); 9 patients showed bone marrow edema/osteitis in the parasymphyseal pubic bone without soft tissue changes, 9 patients showed enthesitis with bone marrow edema/osteitis, and 5 patients showed enthesitis without bone marrow edema/osteitis. The median age of patients with active symphysis pubis changes was higher than that of those without active symphysis pubis changes (p < 0.001). C-reactive protein level and erythrocyte sedimentation rate in the active symphysis pubis group were both higher than those of the non-active symphysis pubis group (p = 0.001 and <0.001, respectively). Conclusions: Active inflammatory changes around the pubic symphysis were seen in 18.0 % of the patients diagnosed with axial spondyloarthritis undergoing pelvic MRI, and were associated with older age and elevated acute phase proteins.