Breaking News
July 23, 2018 - Vaxart Announces Publication of the Phase 1 Results of its Oral Norovirus Tablet Vaccine in Journal of Clinical Investigation Insight
July 23, 2018 - Joslin researchers report excessive fetal growth despite well-controlled type 1 diabetes
July 23, 2018 - Former inmates more likely to die of opioid overdose after prison release
July 23, 2018 - Doctors’ ‘gut feelings’ play key role in medical decision making, finds study
July 23, 2018 - Tooth enamel that regrows? Researcher says revolutionary gel could make it possible
July 23, 2018 - ECU researchers develop world’s first blood test that detects melanoma in its early stages
July 23, 2018 - Researchers explore future of houseplants as functional sirens of home health
July 23, 2018 - No Outcome Differences Based on Anesthesia Team Make-Up
July 23, 2018 - Getting to the heart of congenital cardiac defects
July 23, 2018 - Healthy behaviors are not effective in preventing gestational diabetes in obese women
July 23, 2018 - Top of Teachers’ To-Do List: Focus on the Positives
July 23, 2018 - LDL quality is a novel, modifiable cardiovascular risk marker
July 22, 2018 - Researchers identify enzyme as potential new drug target for blood disorders
July 22, 2018 - Research shows that neurons can encode more than one signal at a time
July 22, 2018 - Exposure to secondhand smoke increases the risk of stillbirth
July 22, 2018 - Skin conditions by the numbers
July 22, 2018 - Brain tumour chemotherapy now available to even more NHS patients
July 22, 2018 - Researchers find mugwort pollen as major source of airborne endotoxins
July 22, 2018 - Occupational safety and health at workplace
July 22, 2018 - Pfizer And Lilly Announce Positive Top-Line Results From Phase 3 Trial Of Tanezumab For The Treatment Of Osteoarthritis (OA) Pain
July 22, 2018 - Early supper associated with lower risk of breast and prostate cancer
July 22, 2018 - Survey results identify major inequalities in acute stroke treatment across Europe
July 22, 2018 - Researchers discover promising treatment for genetic form of autism spectrum disorder
July 22, 2018 - Prenatal Depression More Common in Young Moms Today
July 22, 2018 - What helps adults with autism get and keep a job?
July 22, 2018 - Pediatric NEXUS Head CT DI guides selective imaging decisions in blunt trauma patients
July 22, 2018 - Novel tool predicts genes that cause disease due to production of truncated proteins
July 22, 2018 - AHA: Vaping Tied to Blood Clots — in Mice
July 22, 2018 - Study finds therapy dogs effective in reducing symptoms of ADHD
July 22, 2018 - Scientists find reason why malarial parasites are faster than immune cells
July 22, 2018 - Researchers gain more insight into how FUS protein causes ALS and FTLD
July 22, 2018 - Frequency of joint replacements halved in rheumatoid arthritis patients between 1997-2010
July 22, 2018 - QUT researcher highlights growing impact of non-prescription antibiotics supply in pharmacies
July 22, 2018 - UK health communication researcher seeks solutions for disposing leftover medicine
July 22, 2018 - Pfizer Initiates Pivotal Phase 3 Program for Investigational Hemophilia B Gene Therapy Fidanacogene Elaparvovec
July 22, 2018 - Mutation discovered to protect against Alzheimer’s disease in mice
July 22, 2018 - Researchers reveal how patients in urban areas develop multiple, long-term conditions
July 22, 2018 - Replacing conventional cancer treatment with complementary therapy linked to increased risk of death
July 22, 2018 - Study uncovers molecular key for delaying progression of multiple sclerosis
July 22, 2018 - Availability of athletic trainer in high school reduces injury rates in girls’ sports, shows study
July 22, 2018 - FDA Approves Krintafel (tafenoquine) for the Radical Cure of Plasmodium vivax Malaria
July 22, 2018 - Novel nuclear medicine probe will help assess new drugs for neurodegenerative diseases
July 22, 2018 - Physical activity even during exposure to air pollution can reduce risk of heart attack
July 22, 2018 - Scientists discover protein regulator of myelin production
July 22, 2018 - Sleep disturbances associated with higher dementia risk
July 22, 2018 - Scientists move one step further in developing eye drops to treat age-related macular degeneration
July 22, 2018 - Five-Year Stroke Rates Lower After PCI Versus CABG
July 21, 2018 - Alopecia areata – Genetics Home Reference
July 21, 2018 - Study identifies overdose risk factors in youth with substance use disorders
July 21, 2018 - Drug in clinical trials for Parkinson’s disease offers hope for treating heart failure
July 21, 2018 - Coupling free malaria tests with diagnosis-dependent vouchers can improve rational use of ACTs
July 21, 2018 - Sweetness depends on molecular interactions between specific sugars and water in saliva
July 21, 2018 - Muscle fitness is strongly associated with improved rate of ageing in the brain
July 21, 2018 - Resetting E-Prescriptions for Opioids Helps Curb Use: Study
July 21, 2018 - Overuse of antibiotics not what the doctor ordered
July 21, 2018 - Bundled-payment system did not lower costs for serious medical conditions, shows study
July 21, 2018 - Therapy dogs found to be effective in reducing ADHD symptoms in children
July 21, 2018 - Could rotating multiple therapists better treat PTSD patients?
July 21, 2018 - Binge drinking impairs working memory in adolescent brain
July 21, 2018 - Dying at home could be beneficial for terminally ill cancer patients and their relatives
July 21, 2018 - Researchers identify subtypes of retinal ganglion cells using single-cell RNA sequencing
July 21, 2018 - Study uncovers opportunities to reduce death by suicide among cancer patients
July 21, 2018 - Genetic sequencing reveals new clues to aggressiveness of prostate cancer
July 21, 2018 - BioSight Launches a Phase 2b Clinical Trial of BST-236 as a First-Line Treatment of Acute Myeloid Leukemia
July 21, 2018 - First major study comparing robotic to open surgery published in The Lancet
July 21, 2018 - ADHD medications may fail to improve cognition in healthy college students, study shows
July 21, 2018 - Intervention program that includes a personalized app could benefit teens with suicidal thoughts
July 21, 2018 - Researchers identify new compound that protects against neurodegeneration
July 21, 2018 - Gene therapy may hold potential to treat people with spinal cord injuries
July 21, 2018 - FDA Approves Nivestym (filgrastim-aafi), a Biosimilar to Neupogen
July 21, 2018 - Surgeons have substantial impact on genetic testing in breast cancer patients who need it
July 21, 2018 - Species diversity can have positive and negative impacts on disease transmission
July 21, 2018 - Genome research suggests presence of enteric fever in medieval Europe
July 21, 2018 - Risk of Sensory Deficits Drops With Rising Gestational Age
July 21, 2018 - Mum’s sleep matters—the effect of sleep on an unborn baby
July 21, 2018 - UC San Diego researchers awarded two grants for investigating stem cell-based therapies
July 21, 2018 - Cellular ‘garbage disposal’ may actually work on some of the proteins to neuronal development
July 21, 2018 - More Pregnant Women Having Heart Attacks
July 21, 2018 - Acne Breakouts | NIH News in Health
July 21, 2018 - Change health messaging to focus on potential impact to help stop the next pandemic
MRI scans of healthy military recruits reveal sacroiliac joint damage that mimics axial spondyloarthritis

MRI scans of healthy military recruits reveal sacroiliac joint damage that mimics axial spondyloarthritis

image_pdfDownload PDFimage_print

The magnetic resonance imaging (MRI) scans of healthy military recruits showed sacroiliac joint damage similar to that found in axial spondyloarthritis after just six weeks of intensive physical training, reinforcing the importance of exercising caution when interpreting MRI results, according to new research findings presented this week at the 2017 ACR/ARHP Annual Meeting in San Diego.

Axial spondyloarthropathy (axSpa) is an inflammatory disease with low back pain as its main symptom. Spondyloarthritis (SpA) can also affect the arm and leg joints, and organs like the skin, eyes or intestines. Inflammation often affects the entheses, or the sites where ligaments and tendons attach to bones. People in their teens and 20s, especially young men, are most commonly affected.

Physicians often use MRI as a sensitive method to detect bone marrow edema (BME) and structural lesions in patients with axSpA. Mechanical stress is considered an important factor in the disease’s development. However, it is unclear how often these MRI findings would be seen as a result of mechanical stress/intensive physical activity in a non-SpA population to clarify the specificity of these findings for diagnosis.

To learn more about the effects of intensive activity on these joints, researchers in Ghent, Belgium, examined MRI data from a volunteer group of young military recruits who did not have spondyloarthritis.

“The availability of MRI has shortened diagnostic delay in SpA. In the past, diagnosis could only be made when structural damage on an X-ray was visible, and there were no means to detect active inflammation. MRI is a sensitive method for the detection of active sacroiliitis, but there is limited data regarding its specificity. It is important to evaluate this, considering the risk of over diagnosing SpA,” said Thomas Renson, MD, a researcher at Ghent University in Belgium and a lead author of the study. “One of the strengths of our trial is the homogeneity of our study population. All the recruits had a similar physical condition and were well-trained. All the participants followed the same daily training program and were living in the same housing and environmental conditions. Therefore, the possible extrinsic factors that could influence the MRI appearance were the same for every recruit.”

In the study, 22 military recruits were given MRI scans of their sacroiliac joints (MRI-SIJ) before and after six weeks of intense, uniform physical training. Bone marrow edema (BME) and structural lesions on the scans were scored by three trained readers and blinded for time sequence and clinical findings. The Spondyloarthritis Research Consortium of Canada (SPARCC) score was used to assess bone marrow edema. An adjusted method derived from the SPARCC was used to assess the structural lesions, including sclerosis, erosions, fatty lesions and ankylosis. The recruits’ results were also evaluated for agreement with the definition of a positive MRI per the Assessment of Spondyloarthritis (ASAS).

At baseline, 40.9 percent of the recruits already presented with at least one BME lesion. At week six, this number increased to 50 percent. In the recruits who had BME, the mean number of lesions at baseline was 2.4, and rose to 3.7 at week six. In addition, 22.7 percent of recruits had a positive MRI according to the ASAS definition, and this increased to 36.4 percent at the follow-up. Structural lesions in 36.4 percent of recruits were observed at baseline, and 50 percent of the recruits had structural lesions after six weeks of training.

The researchers concluded the high prevalence of lesions at baseline and high proportion of participants meeting the ASAS definition of a positive MRI for sacroiliitis were both striking, significant results.

“There is evidence that biomechanical stress plays an important role in the pathophysiology of SpA. Considering that none of the recruits in this trial have SpA, this trial does not intend to support or counter this claim. It does show the importance of the necessary caution when interpreting MR images of the sacroiliac joint. Since non-SpA patients can have SpA-like MRI lesions, setting the appropriate clinical indication for imaging is very important,” Dr. Renson said.

“MRI can strengthen or weaken your suspicion of SpA, but does not give you 100 percent certainty. The fact that there was a relatively high proportion of participants meeting the ASAS definition of a positive MRI for sacroiliitis underscores again the important difference between diagnostic criteria and classification criteria. The ASAS definition should only be used in a SpA-population. Caution should be warranted when a chronic, aspecific back pain patient walks into the consultation room with limited bone marrow edema on MRI of the SIJ. A wrong diagnosis of SpA is easily made.”

Source:

https://www.rheumatology.org/About-Us/Newsroom/Press-Releases/ID/835/Joint-Damage-in-Healthy-Military-Recruits-May-Mimic-Spondyloarthropathies

Tagged with:

About author

Related Articles