AKSİYEL SPONDİLOARTRİT HASTALARINDA SAKROILIYAK MR BULGULARININ DEMOGRAFIK ÖZELLİKLER VE AKTIVITE BULGULARI ILE KARŞILAŞTIRILMASI

Abstract

ABSTRACT

Muradlı Hacısoy.N; Comparison of Sacroiliac MRI Findings with Demographic Characteristics and Activity Findings in Axial Spondyloarthritis Patients; Hacettepe University Faculty of Medicine, Department of Internal Medicine Residency Thesis; Ankara, 2023. Spondyloarthritis (SpA) represents a heterogeneous group of diseases showing various common features such as sacroiliitis, spondylitis, enthesitis, more prominent arthritis in the lower extremities, dactylitis, uveitis, and Human Leukocyte Antigen-B27 (HLA-B27) positivity. In our study, we aimed to provide information on how reliable and clinically significant magnetic resonance imaging (MRI) findings are compared to other activity parameters in early diagnosis and the prevention of long-term functional loss and late complications in progressive spondyloarthritis and with disease-modifying therapy. Data of patients with SpA (n=3485) were evaluated in our study. Sacroiliac MR (SI MR) data (n=546) taken before or during treatment were included. The SI MR findings taken before starting bDMARD (n=327) were compared with the demographic characteristics of the patients. Demographic information (age, gender), patient group's place of origin, family history, smoking history, comorbidities, year of diagnosis, treatments, laboratory tests (HLA-B27, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)), clinical findings (peripheral joint involvement, uveitis, psoriasis), disease activity scores (VAS, BASDAI, BASFI) were evaluated and recorded from the database. Additionally, lumbar MR, hip MR, thoracic MR, cervical MR, hand-wrist MR, and sternoclavicular MR data of the patients were included and compared. As a result of the study, it was observed that osteitis (%51.4) was more commonly detected in active lesions of SI MR than erosion (%38.8) in chronic lesions. Sclerosis was more common in men, and ankylosis in women among the lesions, and there was no significant difference between genders in osteitis and erosion. Enthesitis and capsulitis from spinal lesions were found to be associated with HLA B27 positivity. In the evaluation of general spinal MR findings, facet joint inflammation (%14.3) was the most common active inflammatory lesion in lumbar MR, and corner lesions (%10.5) from thoracic MR findings were more frequent. In the comparison of active inflammatory lesions and degenerative lesions, it was observed that degenerative lesion involvement was more prominent in lumbar, thoracic, and cervical MR. Keywords: Axial Spondyloarthritis, Sacroiliac MR, Active Inflammatory lesion, Osteitis