Advanced

The clinical utility of computed tomography compared to conventional radiography in diagnosing sacroiliitis. A retrospective study on 910 patients and literature review

Geijer, Mats LU ; Gothlin, Gro Gadeholt and Gothlin, Jan H. (2007) In Journal of Rheumatology 34(7). p.1561-1565
Abstract
Objective. Ankylosing spondylitis (AS) is a progressive, debilitating disease with complex symptoms, unclear etiology and pathogenesis, and difficult diagnosis. Current imaging methods are useful in diagnosing AS and other spondyloarthropathies, and are frequently used in investigations of sacroiliitis. The radiographic diagnosis of sacroiliitis has large interobserver variations. Computed tomography (CT) has been used for evaluation of sacroiliitis since 1979, and has been evaluated in several studies, most of them with a limited number of patients. These studies have shown a large number of false-negative results from radiography. Methods. In a retrospective study of clinical data, we evaluated 910 patients with AS who were examined by... (More)
Objective. Ankylosing spondylitis (AS) is a progressive, debilitating disease with complex symptoms, unclear etiology and pathogenesis, and difficult diagnosis. Current imaging methods are useful in diagnosing AS and other spondyloarthropathies, and are frequently used in investigations of sacroiliitis. The radiographic diagnosis of sacroiliitis has large interobserver variations. Computed tomography (CT) has been used for evaluation of sacroiliitis since 1979, and has been evaluated in several studies, most of them with a limited number of patients. These studies have shown a large number of false-negative results from radiography. Methods. In a retrospective study of clinical data, we evaluated 910 patients with AS who were examined by radiography and CT within a 2-year period. The reported outcomes from radiography and CT were compared. Results. The agreement between radiography and CT data was only fair, with a kappa value of 0.2418. There were 35.0% false-positive radiography reports, 22.5% false-negative radiography reports, and 86.0% false-equivocal radiography reports. In total, 41.3% of all radiological reports gave a false answer. While the number of false negatives was similar to that previously reported, the number of false positives was much higher than previously reported, and is probably similar to everyday radiology reporting. Conclusion. Our results indicate that the clinical utility of radiography for evaluation of sacroiliitis is limited. The high rate of inaccurate results should motivate the use of sectional imaging for its superior performance. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
X-ray computed, radiography, comparative studies, tomography, diagnosis, ankylosing spondylitis, spondyloarthropathies
in
Journal of Rheumatology
volume
34
issue
7
pages
1561 - 1565
publisher
J Rheumatol Publ Co
external identifiers
  • wos:000248017700022
  • scopus:34447544254
ISSN
0315-162X
language
English
LU publication?
yes
id
af00c814-63f8-4ead-97af-bc253c199b51 (old id 648351)
alternative location
http://www.jrheum.com/subscribers/07/07/1561.html
date added to LUP
2007-12-07 12:03:54
date last changed
2017-08-27 03:50:16
@article{af00c814-63f8-4ead-97af-bc253c199b51,
  abstract     = {Objective. Ankylosing spondylitis (AS) is a progressive, debilitating disease with complex symptoms, unclear etiology and pathogenesis, and difficult diagnosis. Current imaging methods are useful in diagnosing AS and other spondyloarthropathies, and are frequently used in investigations of sacroiliitis. The radiographic diagnosis of sacroiliitis has large interobserver variations. Computed tomography (CT) has been used for evaluation of sacroiliitis since 1979, and has been evaluated in several studies, most of them with a limited number of patients. These studies have shown a large number of false-negative results from radiography. Methods. In a retrospective study of clinical data, we evaluated 910 patients with AS who were examined by radiography and CT within a 2-year period. The reported outcomes from radiography and CT were compared. Results. The agreement between radiography and CT data was only fair, with a kappa value of 0.2418. There were 35.0% false-positive radiography reports, 22.5% false-negative radiography reports, and 86.0% false-equivocal radiography reports. In total, 41.3% of all radiological reports gave a false answer. While the number of false negatives was similar to that previously reported, the number of false positives was much higher than previously reported, and is probably similar to everyday radiology reporting. Conclusion. Our results indicate that the clinical utility of radiography for evaluation of sacroiliitis is limited. The high rate of inaccurate results should motivate the use of sectional imaging for its superior performance.},
  author       = {Geijer, Mats and Gothlin, Gro Gadeholt and Gothlin, Jan H.},
  issn         = {0315-162X},
  keyword      = {X-ray computed,radiography,comparative studies,tomography,diagnosis,ankylosing spondylitis,spondyloarthropathies},
  language     = {eng},
  number       = {7},
  pages        = {1561--1565},
  publisher    = {J Rheumatol Publ Co},
  series       = {Journal of Rheumatology},
  title        = {The clinical utility of computed tomography compared to conventional radiography in diagnosing sacroiliitis. A retrospective study on 910 patients and literature review},
  volume       = {34},
  year         = {2007},
}