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Computed tomography scanning facilitates the diagnosis of sacroiliitis in patients with suspected spondylarthritis: results of a prospective multicenter French cohort study.

Abstract : OBJECTIVE: To assess the performance of computed tomography (CT) scanning for ascertaining sacroiliitis in patients with suspected spondylarthritis (SpA). METHODS: The Echography in Spondylarthritis French cohort consists of 489 patients with suspected SpA. At baseline, all patients underwent clinical examination, HLA-B typing, and pelvic radiography. Pelvic CT scanning was performed if sacroiliitis on radiography was considered uncertain or if patients presented with buttock pain duration of >6 months. A set of 100 paired radiographs and CT scans was read in a blinded manner by 2 radiologists, and the kappa coefficient was used to assess their interreader reliability. One of the radiologists read the 173 available pairs of radiographs and CT scans performed at baseline. RESULTS: After training, interreader reliability was moderate for sacroiliitis grading on radiographs (κ = 0.59), excellent on CT scans (κ = 0.91), and excellent for ascertaining sacroiliitis on both radiographs (κ = 1) and CT scans (κ = 0.96). The first and second readers considered the quality of imaging to be excellent in 66% and 67%, respectively, of the radiographs (κ = 0.88) and in 93% and 92%, respectively, of the CT scans (κ = 0.93). Concordance between radiographs and CT scans was low for sacroiliitis grading (κ = 0.08) or ascertainment (κ = 0.16). Definite sacroiliitis was ascertained on radiographs in 6 patients (3.5%) (confirmed by CT scans in 4 patients) and on CT scans in 32 patients (18.5%). A history of uveitis was associated with definite sacroiliitis on radiographs (P = 0.04) and CT scans (P < 0.0001). CONCLUSION: Definite sacroiliitis was underestimated by radiography, as compared to CT scanning. CT scanning should facilitate the diagnosis of ankylosing spondylitis in patients with suspected SpA.
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https://hal.univ-brest.fr/hal-00730854
Contributor : Ghislaine Calvez <>
Submitted on : Tuesday, September 11, 2012 - 12:08:21 PM
Last modification on : Saturday, October 24, 2020 - 3:40:53 AM

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Valérie Devauchelle-Pensec, Maria Antonietta d'Agostino, Julien Marion, Marie Lapierre, Sandrine Jousse-Joulin, et al.. Computed tomography scanning facilitates the diagnosis of sacroiliitis in patients with suspected spondylarthritis: results of a prospective multicenter French cohort study.. Arthritis and Rheumatism, Wiley, 2012, 64 (5), pp.1412-9. ⟨10.1002/art.33466⟩. ⟨hal-00730854⟩

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