The American College of Rheumatology and European League Against Rheumatism agree that the decision to repeat MRI to assess disease activity or monitor for disease response depends on the clinical circumstances [22,30]. Specifically, MRI of the sacroiliac joints may be helpful for cases in which the disease activity is unclear, available clinical or laboratory data are conflicting, or knowledge of MRI findings is expected to alter treatment [30]. MRI can also detect chronic structural changes on axSpA in the sacroiliac joints, although the clinical utility of follow-up for that purpose is not established [137]. Noncontrast and contrast-enhanced MRI have overall similar diagnostic utility for evaluation of the sacroiliac joints in axSpA [107-111]. The Spondyloarthritis Research Consortium of Canada method has been utilized as a scoring system for quantification and follow-up of lesions at the sacroiliac joints on MRI [138]. MRI Sacroiliac Joints and Spine Area of Interest There is no standard method of following patients with MRI to evaluate for treatment response or disease progression [22,30]. Although multiple studies demonstrate decreasing inflammation on MRI following treatment with TNF-inhibitors, including some long-term studies showing sustained reduction in inflammation, the degree to which MRI findings correlate with disease activity is variable [30]. The American College of Rheumatology and European League Against Rheumatism agree that the decision to repeat MRI to assess disease activity or monitor for disease response depends on the clinical circumstances [22,30]. Specifically, MRI of the sacroiliac joints and spine may be helpful for cases in which the disease activity is unclear, available clinical or laboratory data are conflicting, or knowledge of MRI findings is expected to alter treatment [30].
Inflammatory Back Pain Known or Suspected Axial Spondyloarthropathy PCAs. The American College of Rheumatology and European League Against Rheumatism agree that the decision to repeat MRI to assess disease activity or monitor for disease response depends on the clinical circumstances [22,30]. Specifically, MRI of the sacroiliac joints may be helpful for cases in which the disease activity is unclear, available clinical or laboratory data are conflicting, or knowledge of MRI findings is expected to alter treatment [30]. MRI can also detect chronic structural changes on axSpA in the sacroiliac joints, although the clinical utility of follow-up for that purpose is not established [137]. Noncontrast and contrast-enhanced MRI have overall similar diagnostic utility for evaluation of the sacroiliac joints in axSpA [107-111]. The Spondyloarthritis Research Consortium of Canada method has been utilized as a scoring system for quantification and follow-up of lesions at the sacroiliac joints on MRI [138]. MRI Sacroiliac Joints and Spine Area of Interest There is no standard method of following patients with MRI to evaluate for treatment response or disease progression [22,30]. Although multiple studies demonstrate decreasing inflammation on MRI following treatment with TNF-inhibitors, including some long-term studies showing sustained reduction in inflammation, the degree to which MRI findings correlate with disease activity is variable [30]. The American College of Rheumatology and European League Against Rheumatism agree that the decision to repeat MRI to assess disease activity or monitor for disease response depends on the clinical circumstances [22,30]. Specifically, MRI of the sacroiliac joints and spine may be helpful for cases in which the disease activity is unclear, available clinical or laboratory data are conflicting, or knowledge of MRI findings is expected to alter treatment [30].