How do you manage inflammatory back pain when X-rays and MRI show no evidence of sacroiliitis?
Is an MRI necessary to diagnose non-radiographic axial spondyloarthritis?
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Would you consider a trial of biologic such as TNFi in a patient with symptoms of active inflammatory back pain despite PT and NSAIDs, but normal sacrum MRI?
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2 Answers
Mednet MemberInvited Expert
Rheumatology · Vanderbilt University Medical Center
Answered on · Updated on
While a normal MRI makes the diagnosis of axial spondyloarthritis unlikely, it doesn’t completely rule it out. This is specifically true in patients with inflammatory back pain or other features of spondyloarthritis. While classification criteria definitely should not be used for diagnosis, it is he...
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Mednet Member
Rheumatology · Brookdale University Hospital Medical Center
Answered on
I would also add that negative MRI results need to be interpreted in the context of current NSAIDs' use as anti-inflammatory meds that can mask sacroiliitis.
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