Gaëlle Varkas1,2, Manouk de Hooge1,2, Thomas Renson1, Sophie De Mits1,3, Philippe Carron1,2, Peggy Jacques1, Muriel Moris1, Geert Souverijns4, Lennart Jans5, Dirk Elewaut1,2, Filip Van den Bosch1,2. 1. Department of Rheumatology, Military Hospital Queen Astrid, Belgian Defence, Brussels. 2. VIB Inflammation Research Centre, Military Hospital Queen Astrid, Belgian Defence, Brussels. 3. Rehabilitation Sciences and Physical Therapy, Ghent University, Military Hospital Queen Astrid, Belgian Defence, Brussels. 4. Department of Radiology, Jessa Hospital, Hasselt. 5. Department of Radiology, Ghent University, Ghent, Belgium.
Abstract
Objective: To assess the baseline condition of the SI joints (SIJs) in healthy individuals without symptoms of back pain and to study the effect of mechanical stress caused by intense physical training on MRI of the SIJs. Methods: Twenty-two military recruits underwent an MRI of the SIJs before and after 6 weeks of intense standardized physical training. Bone marrow oedema and structural lesions were scored based on the Spondyloarthritis Research Consortium of Canada (SPARCC) method, by three trained readers blinded for time sequence and clinical findings. Additionally, fulfilment of the Assessment of SpondyloArthritis international Society (ASAS) definition of a positive MRI was evaluated. Results: At baseline, 9/22 recruits (40.9%) already presented a SPARCC score ⩾1; this number increased to 11/22 (50.0%) at week 6 (P = 0.625). In these patients, the mean (SD) SPARCC score was 2.4 (0.4) at baseline, compared to 3.7 (1.3) at week 6. Overall, the mean (SD) change in SPARCC score over time in all 22 patients was 0.9 (0.6) (P = 0.109). A positive MRI according to the ASAS definition was present in 5/22 recruits (22.7%) at baseline, which increased to 8/22 (36.4%) at follow-up (P = 0.375). Structural lesions were present in 6/22 subjects (27.3%), both at baseline and after 6 weeks of training. Conclusion: A substantial proportion of healthy active individuals without any symptoms of back pain displayed bone marrow oedema lesions on MRI at baseline. However, MRI lesions did not increase significantly after 6 weeks of intensive physical training. Our study underscores the necessity to interpret MRI findings of the SIJs in the appropriate clinical context, even in a young active population.
Objective: To assess the baseline condition of the SI joints (SIJs) in healthy individuals without symptoms of back pain and to study the effect of mechanical stress caused by intense physical training on MRI of the SIJs. Methods: Twenty-two military recruits underwent an MRI of the SIJs before and after 6 weeks of intense standardized physical training. Bone marrow oedema and structural lesions were scored based on the Spondyloarthritis Research Consortium of Canada (SPARCC) method, by three trained readers blinded for time sequence and clinical findings. Additionally, fulfilment of the Assessment of SpondyloArthritis international Society (ASAS) definition of a positive MRI was evaluated. Results: At baseline, 9/22 recruits (40.9%) already presented a SPARCC score ⩾1; this number increased to 11/22 (50.0%) at week 6 (P = 0.625). In these patients, the mean (SD) SPARCC score was 2.4 (0.4) at baseline, compared to 3.7 (1.3) at week 6. Overall, the mean (SD) change in SPARCC score over time in all 22 patients was 0.9 (0.6) (P = 0.109). A positive MRI according to the ASAS definition was present in 5/22 recruits (22.7%) at baseline, which increased to 8/22 (36.4%) at follow-up (P = 0.375). Structural lesions were present in 6/22 subjects (27.3%), both at baseline and after 6 weeks of training. Conclusion: A substantial proportion of healthy active individuals without any symptoms of back pain displayed bone marrow oedema lesions on MRI at baseline. However, MRI lesions did not increase significantly after 6 weeks of intensive physical training. Our study underscores the necessity to interpret MRI findings of the SIJs in the appropriate clinical context, even in a young active population.
Authors: Alexis Jones; Timothy J P Bray; Peter Mandl; Margaret A Hall-Craggs; Helena Marzo-Ortega; Pedro M Machado Journal: Rheumatology (Oxford) Date: 2019-11-01 Impact factor: 7.580
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