AB0888 Distribution of active inflammatory lesions on magnetic resonance imaging of the the sacroiliac joints and the spine in patients with early axial spondyloarthritis –results of the esther trial at baseline
Authors: I.-H. Song, C. Althoff, H. Haibel, J. Listing, A. Weiss, B. Freundlich, M. Rudwaleit, B. Hamm, K.-G. Hermann, J. Sieper
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objectives</h3> To address the question whether active inflammation starts at specific sites of the sacroiliac joints (SI-joints) and/or the spine. <h3>Methods</h3> Wb-MRIs of 75 patients with early axial spondyloarhtritis (SpA) with a disease duration of &lt;5 years [1] were scored for active inflammatory lesions on STIR sequences and T1 weighted images in the 23 vertebral units (VUs) of the spine and in the 8 sacroiliac (SI)-joint quadrants. Scoring was performed by two blinded radiologists. <h3>Results</h3> In the total group of patients, 52% (39/75) showed active inflammation only at the SI-joints (active sacroiliitis), 41.3% (31/75) in the SI-joints and the spine and 5.3 (4/75) only in the spine (isolated spinal inflammation). Mean scores for active inflammatory changes were 6.7 (SD 5.8) out of possible 24 points for the SI-joints and 1.9 (SD 3.3) out of possible 69 for the spine. Active inflammation in the SI-joint quadrants were found as the following (in decreasing order): quadrant I (sacral bone, upper quadrant; 66% of patients, n=50); quadrant II (sacral bone, lower quadrant; 60%, n=45), quadrant IV (iliac bone, upper quadrant, 53%, n=40), quadrant III (iliac bone, lower quadrant, 69%, n=52). The most frequently affected sites of active inflammation in the spine were the lower thoracic spine and the lumbar spine: in decreasing order the most frequently affected VUs were T6/T7 (n=11), T10/T11 (n=11), T7/T8 (n=10), L1/L2 (n=10) and L4/L5 (n=9) and L5/S1 (n=9). The cervical spine was less often affected. <h3>Conclusions</h3> In this cohort of early axial SpA patients there was no significant predilection of SI-joint quadrants affected by active inflammtion. In the spine the thoracic and lumbar parts were mostly affected. <h3>References</h3> Song I.-H. et al. 2011. Ann Rheum Dis. 2011 Apr;70(4):590-6. <h3>Disclosure of Interest</h3> I.-H. Song Speakers Bureau: Pfizer/Wyeth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals: consulting fees or other remuneration. C. Althoff: None Declared, H. Haibel Speakers Bureau: Pfizer/Wyeth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals: consulting fees or other remuneration. J. Listing: None Declared, A. Weiss: None Declared, B. Freundlich Employee of: Former employee from Pfizer, M. Rudwaleit Speakers Bureau: Pfizer/Wyeth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals, UCB: consulting fees or other remuneration. B. Hamm: None Declared, K.-G. Hermann: None Declared, J. Sieper Grant/Research support from: Study sponsored with unrestricted grant from Pfizer/Wyeth, Speakers Bureau: Pfizer/Wyeth Pharmaceuticals, Merck Sharp Dohme/Schering Plough, Abbott Immunology Pharmaceuticals, UCB: consulting fees or other remuneration.