Data‐Driven Magnetic Resonance Imaging Definitions for Active and Structural Sacroiliac Joint Lesions in Juvenile Spondyloarthritis Typical of Axial Disease: A Cross‐Sectional International Study
Authors' conclusion
We propose data-driven cutoffs for active inflammatory and structural lesions on MRI typical of axial disease in juvenile SpA that have high specificity and sensitivity using central imaging global assessment as the reference standard and excellent reliability.
Study context
- Population
- International cross-section of juvenile spondyloarthritis (SpA) patients with sacroiliac (SI) joint magnetic resonance imaging (MRI) (61% male, median age 14.9 years)sequences available for detailed scoring
- Participants
- 243 participants
- Exposure
- Inflammatory lesion cutoff vs Structural lesion cutoff
- Outcome
- Sensitivity and specificity of quantitative SI joint MRI lesion cutoffs vs rater majority (≥4 of 6) global assessment of lesions typical of axial SpA with high confidence
Methodological detailsinternational, blinded central reading by 6 musculoskeletal imaging experts, independent validation cohort
- International
- Blinded central reading by 6 musculoskeletal imaging experts
- Independent validation cohort
Main finding
As reported in the abstract
Optimal cutoffs for lesions typical of axial disease in juvenile SpA
| Strategy | Sensitivity | Specificity |
|---|---|---|
| Inflammatory lesion cutoff | 98.6% | 96.5% |
| Structural lesion cutoff | 98.6% | 95.5% |
Sensitivity
Inflammatory lesion cutoff98.6%
Structural lesion cutoff98.6%
Specificity
Inflammatory lesion cutoff96.5%
Structural lesion cutoff95.5%
Observational data: associations, not effects.
Further findings
Validation cohort performance
- Sensitivity and specificity of the optimal cutoffs in the validation cohort were excellent
Original publication
Data‐Driven Magnetic Resonance Imaging Definitions for Active and Structural Sacroiliac Joint Lesions in Juvenile Spondyloarthritis Typical of Axial Disease: A Cross‐Sectional International Study. Arthritis Care Res (Hoboken). Published 18 January 2023. doi:10.
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