Evaluation of the current use of MRI to aid the diagnosis of axial spondyloarthritis in the UK: results from a freedom of information request

T J P Bray; J Eddison; J Hamilton; D Webb; A Bennett; P M Machado; K Gaffney; R Sengupta; M A Hall-Craggs; H Marzo-Ortega

doi:10.1016/j.crad.2023.10.009

Evaluation of the current use of MRI to aid the diagnosis of axial spondyloarthritis in the UK: results from a freedom of information request

Clin Radiol. 2024 Feb;79(2):107-116. doi: 10.1016/j.crad.2023.10.009. Epub 2023 Oct 28.

Authors

T J P Bray¹, J Eddison², J Hamilton², D Webb², A Bennett³, P M Machado⁴, K Gaffney⁵, R Sengupta⁶, M A Hall-Craggs⁷, H Marzo-Ortega⁸

Affiliations

¹ Centre for Medical Imaging, University College London, London, UK; Department of Imaging, University College London Hospital, London, UK. Electronic address: t.bray@ucl.ac.uk.
² National Axial Spondyloarthritis Society, London, UK.
³ Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Unit, Loughborough, UK; National Heart and Lung Institute, Imperial College, London, UK.
⁴ Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, UK.
⁵ Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
⁶ Royal National Hospital for Rheumatic Diseases and University of Bath, Bath, UK.
⁷ Centre for Medical Imaging, University College London, London, UK; Department of Imaging, University College London Hospital, London, UK.
⁸ NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.

PMID: 37968226
DOI: 10.1016/j.crad.2023.10.009

Abstract

Aim: To evaluate the impact of recommendations from the 2019 consensus exercise conducted by radiologists and rheumatologists on the use of magnetic resonance imaging (MRI) to investigate axial spondyloarthritis (axSpA) in clinical practice.

Materials and methods: A freedom of information (FOI) request was used to assess the use of MRI in the diagnosis of axSpA and radiologists' awareness of the 2019 guidance across all NHS Trusts and Health Boards in the UK, including England, Scotland, Northern Ireland, and Wales.

Results: The FOI request was sent to 150 Trusts/Health Boards, and 93 full responses were received. Of the 93 respondents (97%), 90 reported familiarity with the term axSpA and 70/93 (75%) reported familiarity with the 2019 recommendations. Awareness of recommendations regarding specific MRI features supportive of the diagnosis of axSpA was 74/93 (80%) for the sacroiliac joints (SIJs) and 66/93 (71%) for the spine. The median wait for MRI acquisition was 2-3 months. Fifty-two of the 93 (56%) reported at least some outsourcing of axSpA MRI (33%/29% for specialist/non-specialist outsourcing respectively); 32/93 (34%) reported some scans being reported in-house by non-musculoskeletal radiologists.

Conclusion: There have been several positive developments in the understanding and use of MRI for the diagnosis of axSpA in the UK since the 2017 survey, although substantial scope for further improvement remains. Several new challenges have also emerged, including the increase in waiting times, reliance on outsourcing, and the reporting of MRI by non-musculoskeletal radiologists.

MeSH terms

Axial Spondyloarthritis*
Freedom
Humans
Magnetic Resonance Imaging
Sacroiliac Joint / diagnostic imaging
Sacroiliac Joint / pathology
Spondylarthritis* / diagnostic imaging
United Kingdom