• M van Onna, A G Jurik, D van der Heijde, A van Tubergen, L Heuft-Dorenbosch, and R Landewé.
• Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands. m.van.onna@mumc.nl
• Ann. Rheum. Dis. 2011 Nov 1;70(11):1981-5.

ObjectivesTo describe how inflammation on MRI of the sacroiliac joints in patients with recent-onset inflammatory back pain (IBP) evolves over time, and to study determinants of activity on MRI of the sacroiliac joint.MethodsA 2-year follow-up study with annual MRI of the sacroiliac joints was conducted in patients with IBP of less than 2 years' duration. Images were scored for bone marrow oedema on short τ inversion recovery and enhancement after administration of gadolinium on T1.ResultsOf the 68 patients (38% male; mean age 34.9 ± 10.3 years) enrolled, 44 had a negative baseline MRI. Of these 44 patients, 39 patients had at least one follow-up MRI of whom six patients (15%) developed activity on MRI during follow-up. 24 patients (35%) had an abnormal MRI at baseline. In 23 of these 24 patients follow-up MRI was available. The MRI became negative in seven of these 23 patients (30%) during follow-up. Human leucocyte antigen B27 (HLA-B27) positivity and male gender determined independently the likelihood of a positive MRI at any time point. In an HLA-B27-positive patient the likelihood of a positive MRI during follow-up is 88% if the baseline MRI is positive and 27% if the baseline MRI is negative. In an HLA-B27-negative patient with a negative MRI at baseline the likelihood of a positive MRI during follow-up is less than 5%.ConclusionsA positive MRI at baseline predicts a positive MRI during follow-up in HLA-B27-positive patients. A negative MRI at baseline in HLA-B27-negative patients strongly predicts a negative MRI during follow-up.

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