Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging - The Hong Kong Society of Rheumatology

Member List

Chairman
  • Dr Chung, Ho Yin James
  • jameschunghoyin@gmail.com
Members
  • Dr Chan Chiu Wai, Shirley
  • Dr Ciang Chu Oi, Natalia
  • Dr Lau Wing Hang, Vince
  • Dr Lee Kam Ho, Victor
  • Dr Wong Ching Han, Priscilla
  • Dr Wong Pui Yan, Stella

Preface

Axial spondyloarthritis (SpA) is a spectrum of autoimmune diseases characterized by axial joint inflammation and pathological new bone formation.  Encompassing a heterogenous group of rheumatologic conditions including psoriatic arthritis (PsA), inflammatory bowel disease (IBD) related spondyloarthritis, undifferentiated spondyloarthritis (UspA), reactive arthritis (ReA), and ankylosing spondylitis (AS), it is associated with increased risk of cardiovascular (3, 4) and cerebrovascular events (5), and may result in significant functional, social, psychological impairment (1, 2).

Biologic therapies improve prognosis by suppressing inflammation, improving functional status (6), slowing radiographic progression (7), and reducing atherosclerosis (8). However, biologics are not without risks, the most common being non-fatal infection. Upper respiratory tract infection, herpes simplex infection, candida infection, pneumonia, and tuberculosis have been reported (9-11). A rigorous assessment of disease activity on which therapeutic decisions are based becomes increasingly necessary.  Serum markers of inflammation, of which the acute phase reactant C-reactive protein (CRP) is the most clinically used, show only a partial picture of disease activity.  Studies showed CRP performed poorly in reflecting axial disease activity (12), with a weak discriminative power for axial joint inflammation on short tau inversion recovery (STIR) sequence MRI (13). Another commonly used self-assessment tool, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (14), was found to be poorly correlated with spinal inflammation (15). 

Magnetic resonance imaging (MRI) is the main tool for assessment of disease activity due to the absence of reliable serum biomarkers. Inflammation visualized on MRI was found to be correlated with inflammatory cellularity in tissue biopsy (16). In addition, SI joint MRI has diagnostic value in the Assessment of SpondyoArthritis international Society (ASAS) criteria of axial SpA (17). Spinal MRI has also been shown to have additional diagnostic value (18, 19). MRI for assessment of disease activity in equivocal cases is endorsed by the American College of Rheumatology (ACR) / Spondylitis Association of America / Spondyloarthritis Research and Treatment Network (20). MRI scoring systems including the Spondyloarthritis Research Consortium of Canada (SPARCC) MRI indices (21, 22) have been used extensively in research. 

In view of the growing importance of MRI in axial SpA, the Hong Kong Society of Rheumatology (HKSR) has established a special interest group (SIG) to develop and promote the use of MRI in axial SpA, and to provide up-to-date information for local rheumatologists.

MRI SIG Event 2022

MRI Workshop for axial Spondyloarthritis 2023


Date: 25th November, 2023


Time: 9AM-12PM


Venue: Cordis, Hong Kong


Speakers: Dr. Chung Ho Yin, Dr. Victor Lee



  • An overview of MRI sacroiliac joint & Spine

  • Challenges and hidden pitfalls of MRI

  • Highlighted case studies


References