Validez de la gammagrafía ósea de sacroilíacas para el diagnóstico de sacroiliítis en una cohorte colombiana de pacientes con espondiloartritis (SpA)

Abstract

IntroductionRadiological identification of sacroiliitis is essential in the diagnosis of spondyloarthritis. Nuclear Magnetic Resonance has helped to optimize its early detection, leading to improved treatment and a better prognosis for patients. The problem with NMR is that it is expensive and there is limited access to it. For this reason cheaper studies such pelvis x-rays and scintigraphy used more often than nuclear magnetic resonance in clinical practice. ObjectiveTo determine the usefulness of scintigraphy in diagnosing sacroiliitis. MethodsThe 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. ResultsA 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). ConclusionsScintigraphy 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.