Spondyloarthritis & psoriatic arthritis
Redundant radiography before CT in axial spondyloarthritis: high radiation burden, limited diagnostic value
Authors' conclusion
In CT-confirmed r-axSpA, multiple radiographs are frequently obtained before definitive imaging, adding substantial radiation without improving diagnostic yield, whereas a single appropriately indicated low-dose CT could achieve structural assessment with less redundant exposure.
Study context
- Population
- Patients with sacroiliac CT-confirmed radiographic axial SpA (r-axSpA) who had pelvic and lumbar radiographs before CT235 radiographs before CT
- Exposure
- Cumulative radiographic dose before CT vs hypothetical single low-dose CT (0.5 mSv) or conventional CT (4-10 mSv)
- Outcome
- Number and cumulative radiation dose of pelvic and lumbar radiographs obtained before sacroiliac CT-confirmed diagnosis of r-axSpA
Methodological detailsinstitutional and national databases, hypothetical dose scenarios, paired Wilcoxon signed-rank tests
- Institutional and national databases
- Hypothetical dose scenarios
- Paired Wilcoxon signed-rank tests
Main finding
As reported in the abstract
- Radiographs performed before CT
- 235
- Radiographs per patient, mean (range 0-8)
- 2.47
- Patients with ≥2 combined radiographs
- 77.9%
- Under minimum assumptions, radiographic exposure similar to low-dose CT
- P = 0.307
- Under maximum assumptions, exposure markedly higher than low-dose CT (median difference)
- +2.30 mSv, P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Minimum scenario | Maximum scenario |
|---|---|---|
| Patients exceeding a fixed 4.0 mSv conventional CT benchmark | 0 events | 7.4% |
Patients with cumulative X-ray dose ≥0.5 mSv
- Under minimum assumptions
- 10.5%
- Under maximum assumptions
- 82.1%
Original publication
Redundant radiography before CT in axial spondyloarthritis: high radiation burden, limited diagnostic value. Rheumatology (Oxford). Published 3 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →