The incidence of bone marrow oedema at the sacroiliac joints in a non-rheumatological population - a retrospective cohort study

BMC Musculoskelet Disord. 2019 Dec 7;20(1):590. doi: 10.1186/s12891-019-2978-1.

Abstract

Background: The purpose of this study is to determine the incidence of bone marrow oedema (BME) at magnetic resonance imaging (MRI) of the sacroiliac joints (SIJ) in a non- rheumatological population, and to explore whether patient-reported outcome measures are suitable for predicting BME at the SIJ at referral. Furthermore, to investigate the final clinical diagnoses three months after initial SIJ MRI.

Methods: This study was a retrospective cohort study consisting of patients 18-45 years of age that were referred for a SIJ MRI between 1 July 2016 to 30 June 2017 at the Department of Radiology in Lillebaelt Hospital, Denmark. The SIJ MRI radiological reports were evaluated for signs of BME. Principal and secondary diagnoses according to the 10th version of International Classification of Diseases (ICD-10)-three months after the initial MRI-were identified in the electronic patient record system. For a subgroup of patients, patient- reported outcome measures, such as the 23-item Roland Morris Disability Questionnaire, quality of life and pain intensity in the back and leg were included from the local SpineData database.

Results: In total, 333 patients were included, and 187 (56.2%) of those patients received a final diagnosis within three months after the SIJ MRI. BME was detected in 63 (18.9%) patients; 17 (9.1%) patients had both BME at SIJ MRI and were diagnosed with spondyloarthritis (M45/M46). There was no statistically significant difference between patients with and without BME regarding demographics, quality of life, pain descriptions or function.

Conclusions: The incidence of BME in the cohort correlates well to previous studies regarding the incidence of SIJ MRI changes in non-rheumatological populations in Denmark. Patient-reported outcome measures do not seem to contribute to identifying patients with early-phase BME in a non-rheumatological population.

Keywords: EuroQol; MRI; Roland-Morris; Spondyloarthritis; ankylosing spondylitis; cohort study.

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Diseases / diagnosis
  • Bone Marrow Diseases / epidemiology*
  • Bone Marrow Diseases / pathology
  • Denmark / epidemiology
  • Edema / diagnosis
  • Edema / epidemiology*
  • Edema / pathology
  • Female
  • Humans
  • Incidence
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures
  • Quality of Life
  • Retrospective Studies
  • Sacroiliac Joint / diagnostic imaging
  • Sacroiliac Joint / pathology*
  • Spondylarthritis / diagnosis
  • Spondylarthritis / epidemiology*
  • Spondylarthritis / pathology
  • Young Adult