Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging

Objectives Radiography and MRI of the sacroiliac joints (SIJ) are relevant for the diagnosis and classification of patients with axial spondyloarthritis (axSpA). This study aimed to evaluate the impact of clinical information (CI) on the accuracy of imaging interpretation.Methods Out of 109 patients...

Full description

Bibliographic Details
Main Authors: Jürgen Braun, Denis Poddubnyy, Torsten Diekhoff, Fabian Proft, Mikhail Protopopov, Valeria Rios Rodriguez, Murat Torgutalp, Judith Rademacher, Dominik Deppe, Katharina Ziegeler, Tim Pohlner
Format: Article
Language:English
Published: BMJ Publishing Group 2024-04-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/10/2/e004044.full
_version_ 1797221437263577088
author Jürgen Braun
Denis Poddubnyy
Torsten Diekhoff
Fabian Proft
Mikhail Protopopov
Valeria Rios Rodriguez
Murat Torgutalp
Judith Rademacher
Dominik Deppe
Katharina Ziegeler
Tim Pohlner
author_facet Jürgen Braun
Denis Poddubnyy
Torsten Diekhoff
Fabian Proft
Mikhail Protopopov
Valeria Rios Rodriguez
Murat Torgutalp
Judith Rademacher
Dominik Deppe
Katharina Ziegeler
Tim Pohlner
author_sort Jürgen Braun
collection DOAJ
description Objectives Radiography and MRI of the sacroiliac joints (SIJ) are relevant for the diagnosis and classification of patients with axial spondyloarthritis (axSpA). This study aimed to evaluate the impact of clinical information (CI) on the accuracy of imaging interpretation.Methods Out of 109 patients referred because of suspicion of axSpA with complete imaging sets (radiographs and MRI of SIJ), 61 were diagnosed with axSpA (56%). Images were independently evaluated by three radiologists in four consecutive reading campaigns: radiographs and radiographs+MRI without and with CI including demographic data, SpA features, physical activity and pregnancy. Radiographs were scored according to the modified New York criteria, and MRIs for inflammatory and structural changes compatible with axSpA (yes/no). The clinical diagnosis was taken as reference standard. The compatibility of imaging findings with a diagnosis of axSpA (precision) before and after the provision of CI and radiologists’ confidence with their findings (0–10) were evaluated.Results The precision of radiographs evaluation without versus with CI increased from 70% to 78% (p=0.008), and for radiographs+MRI from 81% to 82% (p=1.0), respectively. For CR alone, the sensitivity and specificity of radiologic findings were 51% and 94% without and 60% and 100% with CI, while, for radiographs+MRI, they were 74% and 90% vs 71% and 98%, respectively. The diagnostic confidence of radiologists increased from 5.2±1.9 to 6.0±1.7 with CI for radiographs, and from 6.7±1.6 to 7.2±1.6 for radiographs+MRI, respectively.Conclusion The precision, specificity and diagnostic confidence of radiologic evaluation increased when CI was provided.
first_indexed 2024-04-24T13:05:25Z
format Article
id doaj.art-a135ac2a123748e9953558beac86137d
institution Directory Open Access Journal
issn 2056-5933
language English
last_indexed 2024-04-24T13:05:25Z
publishDate 2024-04-01
publisher BMJ Publishing Group
record_format Article
series RMD Open
spelling doaj.art-a135ac2a123748e9953558beac86137d2024-04-05T08:25:09ZengBMJ Publishing GroupRMD Open2056-59332024-04-0110210.1136/rmdopen-2023-004044Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imagingJürgen Braun0Denis Poddubnyy1Torsten Diekhoff2Fabian Proft3Mikhail Protopopov4Valeria Rios Rodriguez5Murat Torgutalp6Judith Rademacher7Dominik Deppe8Katharina Ziegeler9Tim Pohlner10Ruhr University Bochum, Bochum, Nordrhein-Westfalen, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin, Berlin, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitätsmedizin Berlin, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDepartment of Gastroenterology, Infectious Diseases and Rheumatology (including Clinical Nutrition), Charité-Universitätsmedizin Berlin, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitätsmedizin Berlin, Berlin, GermanyObjectives Radiography and MRI of the sacroiliac joints (SIJ) are relevant for the diagnosis and classification of patients with axial spondyloarthritis (axSpA). This study aimed to evaluate the impact of clinical information (CI) on the accuracy of imaging interpretation.Methods Out of 109 patients referred because of suspicion of axSpA with complete imaging sets (radiographs and MRI of SIJ), 61 were diagnosed with axSpA (56%). Images were independently evaluated by three radiologists in four consecutive reading campaigns: radiographs and radiographs+MRI without and with CI including demographic data, SpA features, physical activity and pregnancy. Radiographs were scored according to the modified New York criteria, and MRIs for inflammatory and structural changes compatible with axSpA (yes/no). The clinical diagnosis was taken as reference standard. The compatibility of imaging findings with a diagnosis of axSpA (precision) before and after the provision of CI and radiologists’ confidence with their findings (0–10) were evaluated.Results The precision of radiographs evaluation without versus with CI increased from 70% to 78% (p=0.008), and for radiographs+MRI from 81% to 82% (p=1.0), respectively. For CR alone, the sensitivity and specificity of radiologic findings were 51% and 94% without and 60% and 100% with CI, while, for radiographs+MRI, they were 74% and 90% vs 71% and 98%, respectively. The diagnostic confidence of radiologists increased from 5.2±1.9 to 6.0±1.7 with CI for radiographs, and from 6.7±1.6 to 7.2±1.6 for radiographs+MRI, respectively.Conclusion The precision, specificity and diagnostic confidence of radiologic evaluation increased when CI was provided.https://rmdopen.bmj.com/content/10/2/e004044.full
spellingShingle Jürgen Braun
Denis Poddubnyy
Torsten Diekhoff
Fabian Proft
Mikhail Protopopov
Valeria Rios Rodriguez
Murat Torgutalp
Judith Rademacher
Dominik Deppe
Katharina Ziegeler
Tim Pohlner
Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging
RMD Open
title Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging
title_full Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging
title_fullStr Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging
title_full_unstemmed Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging
title_short Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging
title_sort diagnostic accuracy in axial spondyloarthritis a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging
url https://rmdopen.bmj.com/content/10/2/e004044.full
work_keys_str_mv AT jurgenbraun diagnosticaccuracyinaxialspondyloarthritisasystematicevaluationoftheroleofclinicalinformationintheinterpretationofsacroiliacjointimaging
AT denispoddubnyy diagnosticaccuracyinaxialspondyloarthritisasystematicevaluationoftheroleofclinicalinformationintheinterpretationofsacroiliacjointimaging
AT torstendiekhoff diagnosticaccuracyinaxialspondyloarthritisasystematicevaluationoftheroleofclinicalinformationintheinterpretationofsacroiliacjointimaging
AT fabianproft diagnosticaccuracyinaxialspondyloarthritisasystematicevaluationoftheroleofclinicalinformationintheinterpretationofsacroiliacjointimaging
AT mikhailprotopopov diagnosticaccuracyinaxialspondyloarthritisasystematicevaluationoftheroleofclinicalinformationintheinterpretationofsacroiliacjointimaging
AT valeriariosrodriguez diagnosticaccuracyinaxialspondyloarthritisasystematicevaluationoftheroleofclinicalinformationintheinterpretationofsacroiliacjointimaging
AT murattorgutalp diagnosticaccuracyinaxialspondyloarthritisasystematicevaluationoftheroleofclinicalinformationintheinterpretationofsacroiliacjointimaging
AT judithrademacher diagnosticaccuracyinaxialspondyloarthritisasystematicevaluationoftheroleofclinicalinformationintheinterpretationofsacroiliacjointimaging
AT dominikdeppe diagnosticaccuracyinaxialspondyloarthritisasystematicevaluationoftheroleofclinicalinformationintheinterpretationofsacroiliacjointimaging
AT katharinaziegeler diagnosticaccuracyinaxialspondyloarthritisasystematicevaluationoftheroleofclinicalinformationintheinterpretationofsacroiliacjointimaging
AT timpohlner diagnosticaccuracyinaxialspondyloarthritisasystematicevaluationoftheroleofclinicalinformationintheinterpretationofsacroiliacjointimaging