AB1093 INTEROBSERVER AGREEMENT IN MAGNETIC RESONANCE OF SACROILIAC JOINTS ABOUT ACTIVE SACROILIITIS
Authors: A. C. Genç, F. Turkoglu Genc, A. B. Kara, Z. Ozturk, D. Karatas, Ü. Erkorkmaz, Y. Gunduz, E. Gönüllü
Journal: Annals of the Rheumatic Diseases (2020)

Background: Axial spondyloarthritis has characteristic clinical features such as enthesitis, sacroiliitis and spondylitis, and extra-articular manifestations(1). Magnetic resonance imaging (MRI) of sacroiliac (SI) joints is used to detect early sacroiliitis(2). Health institutions in our country carry out some of the radiology reporting services by outsourcing for reasons such as high cost and insufficient number of radiologists(3). Objectives: We decided to evaluate the interobserver agreement in active MRI findings of SI between radiologist of outsourcing radiology services and local/expert radiologist in musculoskeletal diseases. Methods: Between the years of 2015 and 2019, 8100 sacroiliac MRIs were taken at our center. The MRI of 1150 patients who were reported as active or chronic sacroiliitis from these sacroiliac MRIs or whose MRI was considered by the primary physician in favor of sacroiliitis was included in the study. Concordance between Evaluation and Service Procurement was examined using Kappa (k) coefficients. Mc Nemar test was used to compare the evaluation result between two observers. A p-value &lt;0.05 was considered significant. Analyses were performed using commercial software (IBM SPSS Statistics, Version 23.0. Armonk, NY: IBM Corp.) Results: Of the 1150 patients examined in the study, 526 (45.7%) were male and 624 (54.3%) were female. The general average age is 37.20 ± 11.65 and the average age of men and women is 34.98 ± 11.19 and 39.07 ± 11.71 respectively. A statistically significant difference was found between the expert radiologists and outsourcing radiologist reports. In other words, a high level of compatibility was not found among the evaluators (p &lt;0.001). When the consistency between expert radiologist and outsourced radiologist reports was examined, it was observed that there was a medium level of concordance (k = 0.589). Conclusion: The diagnosis of a spondyloarthropathy may be delayed for some reasons. In addition to the insidious course of the disease, being contented with an outsourced radiologist report may delay diagnosis. If the patient’s clinic and MRI report are not consistent, the patient should not be removed from follow-up. References: [1]Braun J. ‘Axial spondyloarthritis including ankylosing spondylitis’ Rheumatology (Oxford). 2018 1;57(suppl_6):vi1-vi3 [2]Jans L, Egund N, Eshed I, Sudoł-Szopińska I, Jurik AG. Sacroiliitis in Axial Spondyloarthritis: Assessing Morphology and Activity. Semin Musculoskelet Radiol. 2018;22: 180–188. [3]Quélin B, Duhamel F. Bringing Together Strategic Outsourcing and Corporate Strategy: European Management Journal. 2003. pp. 647–661. doi:10.1016/s0263-2373(03)00113-0 OUTSOURCING RADIOLOGIST REPORTS TOTAL p NOT ACTIVE SACROILIITIS ACTIVE SACROILIITIS EXPERT RADIOLOGIST REPORTS NOT ACTIVE SACROILIITIS 508 178 686 &lt;0.001 0.589 ACTIVE SACROILIITIS 59 405 464 TOTAL 567 583 1150 Disclosure of Interests: None declared