Limited diagnostic value of unilateral sacroiliitis in scintigraphy in assessing axial spondyloarthritis

Abstract

Objective. To assess the diagnostic value for axial spondyloarthritis (SpA) of unilateral sacroiliitis in scintigraphy in daily clinical practice. Methods. In 207 patients with chronic back pain, the diagnostic value of scintigraphy was assessed retrospectively. The diagnosis made by the rheumatologist (axial SpA vs no axial SpA) was the standard. Results. Sensitivities of scintigraphy for any (unilateral or bilateral), bilateral, and isolated unilateral sacroiliitis were 64.9%, 40.2%, and 24.7%, respectively. Respective specificities were 50.5%, 57.7%, and 92.8%, resulting in likelihood ratios of 1.3, 1.0, and 3.4. Conclusion. Scintigraphy of the sacroiliac joints is of limited value for the diagnosis of axial SpA. Unilateral compared to bilateral sacroiliitis is slightly superior, but is associated with a low sensitivity. The Journal of Rheumatology Copyright © 2010. All rights reserved.