Radiographic scoring systems, such as the Bath Ankylosing Spondylitis Radiology Index for the sacroiliac joints, have been utilized for quantification and follow-up of radiographic progression in patients over time [29,150]. Radiography Sacroiliac Joints and Spine Area of Interest There is no standard method of following patients with radiographs to evaluate for progression of structural changes [22], and the American College of Rheumatology recommends against routine follow-up given the lack of proven benefit [30]. Repeat radiographs can be obtained for counseling patients on the status and prognosis of their disease, although radiographs are more typically performed to evaluate the spine rather than the sacroiliac joints [30]. This is because of the low utility of sacroiliac joint radiographs for detecting disease progression based on the relatively poor intra- and interreader reliability of interpretation [141]. Radiographic follow-up can demonstrate evolving structural changes or bone formation, although these changes occur slowly over time at the sacroiliac joints and spine, often requiring years to detect a change and prompting some authors to suggest a radiographic imaging interval of axSpA patients of no less than 2 years for assessment of disease progression [141,143-145,151-153]. There is evidence that patients on TNF-inhibitors may have slower progression of structural damage at the sacroiliac joints and spine [148,154-156], although there is some disagreement in the literature [149]. Radiographic scoring systems, such as the Bath Ankylosing Spondylitis Radiology Index for the sacroiliac joints and the modified Stoke Ankylosing Spondylitis Spine Score for the spine, have been utilized for quantification and follow-up of radiographic progression over time [29,150,157]. US Sacroiliac Joints US of the sacroiliac joints is not utilized as a routine diagnostic tool in the assessment of treatment response or disease progression.
Inflammatory Back Pain Known or Suspected Axial Spondyloarthropathy PCAs. Radiographic scoring systems, such as the Bath Ankylosing Spondylitis Radiology Index for the sacroiliac joints, have been utilized for quantification and follow-up of radiographic progression in patients over time [29,150]. Radiography Sacroiliac Joints and Spine Area of Interest There is no standard method of following patients with radiographs to evaluate for progression of structural changes [22], and the American College of Rheumatology recommends against routine follow-up given the lack of proven benefit [30]. Repeat radiographs can be obtained for counseling patients on the status and prognosis of their disease, although radiographs are more typically performed to evaluate the spine rather than the sacroiliac joints [30]. This is because of the low utility of sacroiliac joint radiographs for detecting disease progression based on the relatively poor intra- and interreader reliability of interpretation [141]. Radiographic follow-up can demonstrate evolving structural changes or bone formation, although these changes occur slowly over time at the sacroiliac joints and spine, often requiring years to detect a change and prompting some authors to suggest a radiographic imaging interval of axSpA patients of no less than 2 years for assessment of disease progression [141,143-145,151-153]. There is evidence that patients on TNF-inhibitors may have slower progression of structural damage at the sacroiliac joints and spine [148,154-156], although there is some disagreement in the literature [149]. Radiographic scoring systems, such as the Bath Ankylosing Spondylitis Radiology Index for the sacroiliac joints and the modified Stoke Ankylosing Spondylitis Spine Score for the spine, have been utilized for quantification and follow-up of radiographic progression over time [29,150,157]. US Sacroiliac Joints US of the sacroiliac joints is not utilized as a routine diagnostic tool in the assessment of treatment response or disease progression.