ArticlePediatric rheumatology online journal2017
ASAS definition for sacroiliitis on MRI in SpA: applicable to children?
Article in Pediatric rheumatology online journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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20 citing papers in PubMed, 34 citations in OpenAlex.
- Does adding a high-resolution 3D sequence improve the accuracy of erosion detection in pediatric sacroiliac joint MRI?European radiology · 2026Article
- Vertebral fractures and bone health in patients with chronic non-bacterial osteomyelitis at disease onset: insights from the monocentric CAMELOT cohort.Therapeutic advances in musculoskeletal disease · 2025Article
- Preferential involvement of the pelvis and hips along with active sacroiliitis in chronic nonbacterial osteomyelitis: MRI of 97 patients from a single tertiary referral center.European radiology · 2024Article
- A clinical perspective on imaging in juvenile idiopathic arthritis.Pediatric radiology · 2024Review
- Bone marrow edema in children: chronic nonbacterial osteomyelitis and its mimickers.Therapeutic advances in musculoskeletal disease · 2024Review
- MRI in pediatric sacroiliitis, what radiologists should know.Pediatric radiology · 2023Review
- Asymptomatic sacroiliitis detected by magnetic resonance enterography in patients with Crohn's disease: prevalence, association with clinical data, and reliability among radiologists in a multicenter study of adult and pediatric population.Clinical rheumatology · 2022Article
- Automated segmentation of magnetic resonance bone marrow signal: a feasibility study.Pediatric radiology · 2022Article
- Doppler and Spectral Ultrasound of Sacroiliac Joints in Pediatric Patients with Suspected Juvenile Spondyloarthritis.Diagnostics (Basel, Switzerland) · 2022Article
- Recent Updates in Juvenile Spondyloarthritis.Rheumatic diseases clinics of North America · 2021Review
- Normal subchondral high T2 signal on MRI mimicking sacroiliitis in children: frequency, age distribution, and relationship to skeletal maturity.European radiology · 2021Article
- Similarities and Differences Between Juvenile and Adult Spondyloarthropathies.Frontiers in medicine · 2021Review
- The Increased Levels of Fecal Calprotectin in Children With Active Enthesitis Related Arthritis and MRI Signs of Sacroiliitis: The Results of a Single Center Cross-Sectional Exploratory Study in Juvenile Idiopathic Arthritis Patients.Frontiers in medicine · 2021Article
- Imaging assessment of children presenting with suspected or known juvenile idiopathic arthritis: ESSR-ESPR points to consider.European radiology · 2020Review
- Usefulness of magnetic resonance enterography in detecting signs of sacroiliitis in young patients with inflammatory bowel disease.Pediatric rheumatology online journal · 2020Article
- Common incidental findings on sacroiliac joint MRI in children clinically suspected of juvenile spondyloarthritis.European journal of radiology open · 2020Article
- Magnetic resonance imaging of sacroiliitis in children: frequency of findings and interobserver reliability.Pediatric radiology · 2018Article
- Classifications and imaging of juvenile spondyloarthritis.Journal of ultrasonography · 2018Article
- The performance of classification criteria for juvenile spondyloarthropathies.Rheumatology international · 2017Article
- Anatomy of the sacroiliac joints in children and adolescents by computed tomography.Pediatric rheumatology online journal · 2017Article
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Authors and funding
11 authors at 3 institutions in 3 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Assessment of Spondyloarthritis International Society (ASAS) definition for a 'positive' Magnetic Resonance Imaging (MRI) for sacroiliitis is well studied and validated in adults, but studies about the value of this definition in children are lacking. The aim of this study is to evaluate whether the adult ASAS definition of a positive MRI of the sacroiliac joints can be applied to children with a clinical suspicion of Juvenile Spondyloarthritis (JSpA).
methodsTwo pediatric musculoskeletal radiologists blinded to clinical data independently retrospectively reviewed sacroiliac (SI) joint MRI in 109 children suspected of sacroiliitis. They recorded global impression (sacroiliitis yes/no) and whether the adult ASAS definition for sacroiliitis was met at each joint. This was compared to gold-standard clinical diagnosis of JSpA. Additionally, MRI were scored according to'adapted' ASAS definitions including other features of sacroiliitis on MRI.
resultsJSpA was diagnosed clinically in 47/109 (43%) patients. On MRI, sacroiliitis was diagnosed by global assessment in 30/109 patients, of whom 14 also fulfilled ASAS criteria. No patients with negative global assessment for sacroiliitis fulfilled ASAS criteria. Sensitivity (SN) for JSpA was higher for global assessment (SN = 49%) than for ASAS definition (SN = 26%), but the ASAS definition was more specific (SP = 97% vs. 89%). Modifying adult ASAS criteria to allow bone marrow edema (BME) lesions seen on only one slice, synovitis or capsulitis, increased SN to 36%, 32% and 32% respectively, only slightly lowering SP. Including structural lesions increased SN to 28%, but lowered specificity to 95%.
conclusionThe adult ASAS definition for sacroiliitis has low sensitivity in children. A pediatric-specific definition of MRI-positive sacroiliitis including BME lesions visible on one slice only, synovitis and/or capsulitis may improve diagnostic utility, and increase relevance of MRI in pediatric rheumatology practice.
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