Under a system with a score of two as the cut-off for positivity, 12 healthy individuals were diagnosed with axSpA along with 46 actual axSpA patients, five chronic back pain patients, four runners and four women with postpartum back pain. When the cut-off was raised to five or greater, four healthy individuals were found to be positive compared to 41 axSpA participants, one chronic back pain patient and two women with postpartum back pain. No runners were declared positive under these scores.

Researchers, in studying the occurrence of deep BME lesions, concluded such lesions to be a separate matter from sacroiliitis in axSpA patients, finding none in healthy individuals, chronic back pain patients or frequent runners. Lesions were found in 38 axSpA patients and in one woman with postpartum back pain.


Landewé says the results of this study and the others reflect the need for caution in evaluating MR scans for the potential presence of axSpA, and should serve as a reminder to physicians to look at all diagnostic exams performed before determining a diagnosis.

“Use MR, but interpret the results cautiously and in the context of the entire clinical picture (‘pattern recognition’),” he suggests. “Do not rely on a positive MR in a patient without a fitting clinical picture.”

The study was presented alongside a series of others, two of which evaluated positive MR scans for axSpA through the examination of joint damage in military recruits, and the occurrence of BME in young athletes.

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