Subchondral Bone Attenuation Coefficient Utility of the Sacroiliac Margins to Differentiate Spondyloarthritis and Osteitis Condensans Ilii

Overview

Journal RMD Open

Publisher BMJ Publishing Group

Specialty Rheumatology

Date 2022 May 17

PMID 35580924

Authors

Alexandre Terrier

Olivier Fakih

Mickael Chouk

Clement Prati

Daniel Wendling

Sebastien Aubry

Frank Verhoeven

Affiliations

Soon will be listed here.

Abstract

Introduction: Differentiating ankylosing spondylitis (AS) from osteitis condensans ilii (OCI) remains challenging for clinicians. The aim of this study was to determine whether Subchondral Bone Attenuation Coefficient of the SacroIliac margins (SBAC-SI) is different in AS, OCI and diffuse idiopathic skeletal hyperostosis (DISH).

Methods: A monocentric retrospective observational study was performed at the University Hospital of Besançon. Patients included were followed for AS, DISH or OCI and underwent CT scan including sacroiliac joint. Patients with tumour lesion of bone or a history of pelvic radiotherapy were excluded. AS and OCI patients were matched with a control of the same age and sex. SBAC-SI was evaluated by the sum of 24 identical circular regions of interest, 8 per slice (anterior, middle and posterior).

Results: Thirty AS and AS controls, 31 DISH, 29 OCI and OCI controls were included. SBAC-SI score was 9727 (±2430) in the OCI group (p<0.001), 3563 (±1860) in the AS group, 3899 (±1937) in the DISH group, 4224 (±1693) in the AS control group and 5445 (±1205) in the OCI control group. A threshold of 7500 HU had the best discriminative value between OCI and AS (youden index: 0.89). In AS, disease duration is negatively associated with SBAC-SI (r: -0.623; p<0.01) and HLA B27 is associated with lower SBAC-SI (6523 (5198; 7137) vs 2809 (1568; 3371); p<0.001).

Conclusion: SBAC-SI is significatively different between AS and OCI and could help to distinguish these two diseases.

Citing Articles

Significant overlap of inflammatory and degenerative features on imaging among patients with degenerative disc disease, diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis: a real-life cohort study.

Ziade N, Udod M, Kougkas N, Tsiami S, Baraliakos X Arthritis Res Ther. 2024; 26(1):147.

PMID: 39097721 PMC: 11297750. DOI: 10.1186/s13075-024-03359-w.

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