Abstract

ESCOBAR TRUJILLO, Alejandro et al. Accuracy of sacroiliac joint (SIJ) bone scintigraphy in the diagnosis of sacroiliitis in a Colombian cohort with spondyloarthritis (SpA). Rev.Colomb.Reumatol. [online]. 2014, vol.21, n.1, pp.21-26. ISSN 0121-8123.

Introduction: Radiological identification of sacroiliitis is essential in the diagnosis of Sacroiliitis spondyloarthritis. Nuclear Magnetic Resonance has helped to optimize its early detection, Scintigraphy leading to improved treatment and a better prognosis for patients. The problem with NMR Spondyloarthritis is that it is expensive and there is limited access to it. For this reason cheaper studies such Magnetic resonance imaging pelvis x-rays and scintigraphy used more often than nuclear magnetic resonance in clinical practice. Objective: To determine the usefulness of scintigraphy in diagnosing sacroiliitis. Methods: The sensitivity, specificity, positive predictive value, negative predictive value of Bone Scintigraphy were analyzed for the diagnosis of sacroiliitis in a Colombian patient cohort with Spondyloarthritis using nuclear magnetic resonance as the gold standard. Results: A total of 55 patients were analyzed, 43.6% females and 53.3% males, with a mean disease duration of 9.1± years. The mean age of onset of symptoms was 31± years. Undifferentiated spondyloarthritis was the most frequent pathology (60.5%), and mixed pattern was the most common (58.2%). The scintigraphy performance compared to NMR was, sensitivity: 15% (95% CI; 0.04- 0.25), specificity: 81% (95% CI; 0.72- 0.9), positive predictive value: 32% (95% CI; 0.11-0.52), and negative predictive value: 62% (95% CI; 0.52-0.72). Conclusions: Scintigraphy has variable sensitivity but a low specificity, positive predictive value, and negative predictive value, for sacroiliitis detection, thus it can be said that it is not useful in the diagnosis of spondyloarthritis.

Keywords : Sacroiliitis; Scintigraphy; Spondyloarthritis; Magnetic resonance imaging.

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