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Article: Fatty corner lesions in T1-weighted magnetic resonance imaging as an alternative to sacroiliitis for diagnosis of axial spondyloarthritis

TitleFatty corner lesions in T1-weighted magnetic resonance imaging as an alternative to sacroiliitis for diagnosis of axial spondyloarthritis
Authors
KeywordsSpondyloarthropathies
Magnetic resonance imaging
Diagnosis
Back pain
Spine
Issue Date2019
PublisherBioMed Central Ltd. The Journal's web site is located at https://bmcrheumatol.biomedcentral.com/
Citation
BMC Rheumatology, 2019, v. 3, p. 17 How to Cite?
AbstractBackground A fatty corner lesion (FCL) is a well-demarcated fat infiltration in the corner of a vertebral body on T1 magnetic resonance imaging (MRI) sequence. It has been reported to be useful in the diagnosis of axial spondyloarthritis (axSpA). Our objective is to systematically evaluate the diagnostic accuracy of FCLs in tertiary centre patients with chronic back pain. Method Two hundred and thirty eight axSpA patients and 62 non-axSpA patients with back pain were recruited from five rheumatology centres. Clinical, biochemical, and radiological parameters were collected and all patients underwent a MRI of the spine and sacroiliac (SI) joints. FCLs in vertebral bodies from C4 to L5 were scored. The number and location of FCLs were clustered together to determine an optimal combination for diagnosis. Results were compared with expert diagnosis as the “gold standard”. Results FCLs of the anterior whole spine (AUC 0.62; p = 0.003) and anterior thoracic spine (AUC 0.64; p = 0.001) had diagnostic significance. Incorporating at least 5 whole spine FCLs into the imaging criteria of the Assessment of SpondyloArthritis international Society (ASAS) criteria for axSpA yielded a sensitivity of 91.6% and specificity of 91.9%. Similarly, applying at least 3 anterior thoracic FCLs to the imaging criteria of the ASAS axial SpA criteria yielded a sensitivity of 92.0% and specificity of 93.5%. Conclusion FCLs could be used to diagnose axial SpA. The presence of at least 3 anterior thoracic FCLs in T1-weighted MRI spine suggests a diagnosis of axial SpA without additional MRI of the SI joints. Trial registration The cohort has been registered in the clinical trial registry of the University of Hong Kong (HKUCTR-2087).
Persistent Identifierhttp://hdl.handle.net/10722/271255
ISSN
2023 Impact Factor: 2.1
2023 SCImago Journal Rankings: 0.805
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChung, HY-
dc.contributor.authorYiu, RSW-
dc.contributor.authorChan, SCW-
dc.contributor.authorLee, KH-
dc.contributor.authorLau, CS-
dc.date.accessioned2019-06-24T01:06:21Z-
dc.date.available2019-06-24T01:06:21Z-
dc.date.issued2019-
dc.identifier.citationBMC Rheumatology, 2019, v. 3, p. 17-
dc.identifier.issn2520-1026-
dc.identifier.urihttp://hdl.handle.net/10722/271255-
dc.description.abstractBackground A fatty corner lesion (FCL) is a well-demarcated fat infiltration in the corner of a vertebral body on T1 magnetic resonance imaging (MRI) sequence. It has been reported to be useful in the diagnosis of axial spondyloarthritis (axSpA). Our objective is to systematically evaluate the diagnostic accuracy of FCLs in tertiary centre patients with chronic back pain. Method Two hundred and thirty eight axSpA patients and 62 non-axSpA patients with back pain were recruited from five rheumatology centres. Clinical, biochemical, and radiological parameters were collected and all patients underwent a MRI of the spine and sacroiliac (SI) joints. FCLs in vertebral bodies from C4 to L5 were scored. The number and location of FCLs were clustered together to determine an optimal combination for diagnosis. Results were compared with expert diagnosis as the “gold standard”. Results FCLs of the anterior whole spine (AUC 0.62; p = 0.003) and anterior thoracic spine (AUC 0.64; p = 0.001) had diagnostic significance. Incorporating at least 5 whole spine FCLs into the imaging criteria of the Assessment of SpondyloArthritis international Society (ASAS) criteria for axSpA yielded a sensitivity of 91.6% and specificity of 91.9%. Similarly, applying at least 3 anterior thoracic FCLs to the imaging criteria of the ASAS axial SpA criteria yielded a sensitivity of 92.0% and specificity of 93.5%. Conclusion FCLs could be used to diagnose axial SpA. The presence of at least 3 anterior thoracic FCLs in T1-weighted MRI spine suggests a diagnosis of axial SpA without additional MRI of the SI joints. Trial registration The cohort has been registered in the clinical trial registry of the University of Hong Kong (HKUCTR-2087).-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at https://bmcrheumatol.biomedcentral.com/-
dc.relation.ispartofBMC Rheumatology-
dc.rightsBMC Rheumatology. Copyright © BioMed Central Ltd.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectSpondyloarthropathies-
dc.subjectMagnetic resonance imaging-
dc.subjectDiagnosis-
dc.subjectBack pain-
dc.subjectSpine-
dc.titleFatty corner lesions in T1-weighted magnetic resonance imaging as an alternative to sacroiliitis for diagnosis of axial spondyloarthritis-
dc.typeArticle-
dc.identifier.emailChung, HY: jameschy@hku.hk-
dc.identifier.emailLau, CS: cslau@hku.hk-
dc.identifier.authorityChung, HY=rp02330-
dc.identifier.authorityLau, CS=rp01348-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s41927-019-0068-5-
dc.identifier.pmid31161154-
dc.identifier.pmcidPMC6542022-
dc.identifier.scopuseid_2-s2.0-85081085911-
dc.identifier.hkuros298075-
dc.identifier.volume3-
dc.identifier.spage17-
dc.identifier.epage17-
dc.identifier.isiWOS:000648488500017-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl2520-1026-

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