{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T09:03:13Z","timestamp":1772614993521,"version":"3.50.1"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2014,4,22]],"date-time":"2014-04-22T00:00:00Z","timestamp":1398124800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2014,4,22]],"date-time":"2014-04-22T00:00:00Z","timestamp":1398124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>Radiography is an unreliable and insensitive tool for the assessment of structural lesions in the sacroiliac joints (SIJ). Magnetic resonance imaging (MRI) detects a wider spectrum of structural lesions but has undergone minimal validation in prospective studies. The Spondyloarthritis Research Consortium of Canada (SPARCC) MRI Sacroiliac Joint (SIJ) Structural Score (SSS) assesses a spectrum of structural lesions (erosion, fat metaplasia, backfill, ankylosis) and its potential to discriminate between therapies requires evaluation.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>The SSS score assesses five consecutive coronal slices through the cartilaginous portion of the joint on T1-weighted sequences starting from the transitional slice between cartilaginous and ligamentous portions of the joint. Lesions are scored dichotomously (present\/absent) in SIJ quadrants (fat metaplasia, erosion) or halves (backfill, ankylosis). Two readers independently scored 147 pairs (baseline, 2\u00a0years) of scans from a prospective cohort of patients with SpA who received either standard (<jats:italic>n<\/jats:italic>\u2009=\u200969) or tumor necrosis factor alpha (TNF\u03b1) inhibitor (<jats:italic>n<\/jats:italic>\u2009=\u200978) therapy. Smallest detectable change (SDC) was calculated using analysis of variance (ANOVA), discrimination was assessed using Guyatt\u2019s effect size, and treatment group differences were assessed using t-tests and the Mann\u2013Whitney test. We identified baseline demographic and structural damage variables associated with change in SSS score by univariate analysis and analyzed the effect of treatment by multivariate stepwise regression adjusted for severity of baseline structural damage and demographic variables.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>A significant increase in mean SSS score for fat metaplasia (<jats:italic>P<\/jats:italic>\u2009=\u20090.017) and decrease in mean SSS score for erosion (<jats:italic>P<\/jats:italic>\u2009=\u20090.017) was noted in anti-TNF\u03b1 treated patients compared to those on standard therapy. Effect size for this change in SSS fat metaplasia and erosion score was moderate (0.5 and 0.6, respectively). Treatment and baseline SSS score for erosion were independently associated with change in SSS erosion score (\u03b2\u2009=\u20091.75, <jats:italic>P<\/jats:italic>\u2009=\u20090.003 and \u03b2\u2009=\u20090.40, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001, respectively). Change in ASDAS (\u03b2\u2009=\u2009\u22120.46, <jats:italic>P<\/jats:italic>\u2009=\u20090.006), SPARCC MRI SIJ inflammation (\u03b2\u2009=\u2009\u22120.077, <jats:italic>P<\/jats:italic>\u2009=\u20090.019), and baseline SSS score for fat metaplasia (\u03b2\u2009=\u20090.085, <jats:italic>P<\/jats:italic>\u2009=\u20090.034) were independently associated with new fat metaplasia.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusion<\/jats:title>\n                        <jats:p>The SPARCC SSS method for assessment of structural lesions has discriminative capacity in demonstrating significantly greater reduction in erosion and new fat metaplasia in patients receiving anti-TNF\u03b1 therapy.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/ar4548","type":"journal-article","created":{"date-parts":[[2014,4,22]],"date-time":"2014-04-22T09:03:21Z","timestamp":1398157401000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Tumor necrosis factor inhibitor therapy but not standard therapy is associated with resolution of erosion in the sacroiliac joints of patients with axial spondyloarthritis"],"prefix":"10.1186","volume":"16","author":[{"given":"Susanne J","family":"Pedersen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Wichuk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praveena","family":"Chiowchanwisawakit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert G","family":"Lambert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter P","family":"Maksymowych","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2014,4,22]]},"reference":[{"key":"4186_CR1","doi-asserted-by":"publisher","first-page":"2215","DOI":"10.1002\/art.30393","volume":"63","author":"P Chiowchanwisawakit","year":"2011","unstructured":"Chiowchanwisawakit P, Lambert RGW, Conner-Spady B, Maksymowych WP: Focal fat lesions at vertebral corners on magnetic resonance imaging predict the development of new syndesmophytes in ankylosing spondylitis. 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