OBJECTIVE: A recent consensus statement has suggested >= 3 corner inflammatory lesions (CILs) or several @entity8481 ( @entity8481 ) as candidate criteria indicative of @entity1691 (SpA) on magnetic resonance imaging (MRI) of the spine. The aim of this study was to evaluate the diagnostic utility of these cutoffs in nonradiographic axial SpA and @entity1691 ( @entity1691 ). METHODS: One hundred thirty consecutive @entity1 with @entity615 who were  <=50 years of age and newly referred to 2 university clinics (cohorts A and B) were classified according to rheumatologist expert opinion based on results of clinical examination and pelvic radiography as having nonradiographic axial SpA (n = 50), @entity1691 (n = 33), or nonspecific @entity615 (n = 47). Cohort A also included 20 age-matched healthy controls. Four blinded readers assessed MRIs of the spine using the standardized Canada-Denmark module. Readers recorded CILs and @entity8481 in 23 discovertebral units. We tested the diagnostic utility (mean sensitivity and specificity over 4 readers) of the cutoff for the number of lesions on spinal MRI as proposed in the literature (>= 2 or >= 3 CILs and >= 6 @entity8481 ), and we tested for possible thresholds (from >= 1 CIL or CFL to >= 10 CILs or @entity8481 ) for nonradiographic axial SpA and @entity1691 @entity1 in both cohorts. RESULTS: None of the spinal thresholds (>= 2 or >= 3 CILs and >= 6 @entity8481 ) showed clinically relevant diagnostic utility (positive likelihood ratio [LR] range 1.38-2.36) when comparing @entity1 with nonradiographic axial SpA to @entity1 with nonspecific @entity615 . A threshold of >= 6 CILs had moderate to substantial diagnostic utility (positive LR 13.26 and 6.74 in cohorts A and B, respectively) in nonradiographic axial SpA, while >= 4 CILs showed small diagnostic utility (positive LR 3.83 and 2.72 in cohorts A and B, respectively) but specificities of >0.90. CONCLUSION: None of the previously proposed candidate criteria for a positive spinal MRI finding of axial SpA showed clinically relevant diagnostic utility in nonradiographic axial SpA. These results question the value of proposed definitions for a positive finding of SpA based on MRI of the spine alone.

Diagnostic utility of candidate definitions for demonstrating XXXX on magnetic resonance imaging of the spine.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity615 :: ('MESH:D001416', 'Disease') :: ['back pain'] @entity1691 :: ('MESH:D013167', 'Disease') :: ['axial spondyloarthritis', 'ankylosing spondylitis', 'AS'] @entity8481 :: ('MESH:C536351', 'Disease') :: ['corner fatty lesions', 'CFLs']
@entity1691 :: (MESH:D013167,Disease) :: ['axial spondyloarthritis']
