{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:39:31Z","timestamp":1791005971761,"version":"4.1.0"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T00:00:00Z","timestamp":1608508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To analyse the predictive values of inflammatory back pain (IBP), positive HLA B27 antigen, increased C-reactive protein (CRP), Spondyloarthritis (SpA) features, familial history (FH), magnetic resonance sacroiliac joints (MRI-SIJ) imaging and its weight in early SpA diagnosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>133 patients with back pain, aged &lt;50, duration of the pain &lt;2 years were included. Data such as IBP, HLA B27, increased CRP, SpA features, FH, SIJ\u00b4s radiography and MRI were collected for each patient. STIR sequences were classified as strongly positive bone morrow oedema (SPBME \u22652), clearly present and easily recognisable as positive according to the ASAS criterion, weakly positive (WPBME \u22652), suggestive, but not easily recognisable and, clearly negative none of those features. T1-weighted sequences were assessed as positive\/negative for erosion, fat metaplasia, backfill and sclerosis, if \u22651, for each lesion was present. MRI images were read by three blinded readers.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The average age was 38.9 years. 47 (35.3%) patients received SpA diagnosis according to the clinical opinion. IBP was highly specific, 0.81 and sensitive, 0.83. HLA B27 was positive in a half of the SpA patients. SPBME \u22652 provided a great specificity, 0.94 and an acceptable sensitivity, 0.79. Erosion was significantly more frequent in SpA patients (72% vs 7%), specificity 0.93. The addition of erosion \u22651 to the WPBME \u22652 noticeably improved specificity, 0.98, although slightly decreased sensitivity, 0.64. Fat metaplasia and backfill were highly specific, but poorly sensitive. Factors forecasting positive diagnosis were IBP, followed by SpA features and increased CRP.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>At the onset, IBP might be a good marker for selecting patients with suspicion of SpA. The addition of erosion to the ASAS criterion might be helpful for early diagnosis, especially in patients with doubtful STIR imaging where BME is present but it is hard to determinate whether the ASAS \u201chighly suggestive\u201d criterion is met.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0244184","type":"journal-article","created":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T19:08:03Z","timestamp":1608577683000},"page":"e0244184","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Predictive values of inflammatory back pain, positive HLA B27 antigen and acute and chronic magnetic resonance changes in early diagnosis of Spondyloarthritis. A study of 133 patients"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9037-2462","authenticated-orcid":true,"given":"Liliya Yankova","family":"Komsalova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00aa Pilar","family":"Mart\u00ednez Salinas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Ferm\u00edn G\u00f3mez","family":"Jim\u00e9nez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,12,21]]},"reference":[{"issue":"2","key":"pone.0244184.ref001","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1097\/BOR.0b013e3283364483","article-title":"Genetics of ankylosing spondylitis","volume":"22","author":"MA Brown","year":"2010","journal-title":"Curr Opin Rheumatol"},{"issue":"4","key":"pone.0244184.ref002","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/art.1780270401","article-title":"Evaluation of diagnostic criteria for ankylosing spondylitis. 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