Validity of magnetic resonance image and HLA-B27 in early detection of sacroiliitis in Egyptian spondyloarthropathic patients

• Published in: Egyptian Rheumatology and Rehabilitation Vol. 42; no. 3; pp. 137 - 144
• Main Authors: Darwish, Ayman, Ali, Amal, Hamdi, Lamya, Ibrahim, Muhammad, al-Sharif, Ruhiyah R., Ali, Fatimah
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt The Egyptian Society for Rheumatology and Rehabilitation 01-07-2015; Springer Berlin Heidelberg; Springer Nature B.V; SpringerOpen
• Subjects: Diagnosis; Diagnostic use; Diseases; HLA histocompatibility antigens; HLA-B27, MRI, sacroiliitis, spondyloarthropathies; Laboratories; Medicine & Public Health; Original Article; Radiography; Rehabilitation; Sacroiliac joint; Sacroiliitis; الأمراض; التشخيص; sacroiliitis; MRI; HLA-B27; spondyloarthropathies
• DOI: 10.4103/1110-161X.163946
• EISSN: 2090-3235
• ISSN: 1110-161X

Objective
The aim of this study was to compare the validity of MRI in the early detection of sacroiliitis
with laboratory findings of human leukocyte antigen-B27 (HLA-B27), conventional radiography,
and clinical assessment.
Participants and methods
Sixty patients with spondyloarthropathy (group II) with duration of illness less than 2 years
and 20 healthy controls (group I) were included in this study. Both groups were subjected
to assessment of history, clinical examination, and laboratory investigations (erythrocyte
sedimentation rate, C-reactive protein titer, rheumatoid factor, HLA-B27). Conventional
radiography and MRI of the sacroiliac joints were performed. Spondyloarthropathic patients
were divided according to MRI as follows: group IIA, which included patients with sacroiliitis,
and group IIB, which included patients without sacroiliitis.
Results
In our study, ankylosing spondylitis was diagnosed in 22 (36.6%) patients, followed by
undifferentiated spondyloarthropathy in 12 (20%) patients, reactive arthritis in 10 (16.7%)
patients, psoriatic arthropathy in 10 (16.7%) patients, and enteropathic arthropathy in six (10%)
patients. Evidence of sacroiliitis was found in 66.6% (40/60) of patients by MRI, which was
higher than the result obtained by plain radiography 20% (12/60). HLA-B27 positivity found
in 53.3% (32/60) of patients. There was a significant difference between the two groups in
HLA-B27 and radiological sacroiliitis; there was no sacroiliitis in the control group. MRI showed
sacroiliitis even in patients with no inflammatory back pain. There was a highly statistically
significant difference between patient subgroups in disease duration (P = 0.001) and primary
complaints and clinical sacroiliitis (P = 0.001).
Conclusion
MRI is the preferred modality in the detection of early sacroiliitis in spondyloarthropathy and
HLA-B27 positivity is a highly useful predictor of early sacroiliitis