Facet Joint Inflammation Increases Ankylosis Risk in AxSpA

TOPLINE:

Facet joint inflammation is linked to a more than threefold increase in the risk for subsequent ankylosis at the same spinal location in patients with axial spondyloarthritis (axSpA). 

METHODOLOGY:

• Researchers assessed the association between posterior element inflammation, particularly in facet joints, and new facet joint ankylosis in patients with radiographic axSpA in the prospective Sensitive Imaging in Ankylosing Spondylitis cohort.
• Overall, 58 patients (mean age, 49 years; 84% men) with at least one radiographic spinal syndesmophyte who underwent MRI assessments at baseline, 1-year, and 2-year follow-ups were included.
• Inflammatory lesions and facet joint ankylosis were assessed per vertebral unit level in 23 vertebral units by three independent readers.

TAKEAWAY:

• At baseline, 59% of the patients had posterior element inflammation, with facet joint inflammation reported in 24%.
• Facet joint inflammation was infrequently present, with a higher prevalence in the upper thoracic spine (2%-5%).
• Facet joint ankylosis was seen in 26% of the patients at baseline and 29% of the patients during follow-up visits and was mostly reported in the upper half of the spine.
• Facet joint inflammation was associated with a more than threefold increase in the risk for incident ankylosis at the same site 1 year later (odds ratio, 3.79; 95% CI, 1.47-9.75).

IN PRACTICE:

"The findings of this study underline the relationship between inflammation and ankylosis in axSpA, demonstrating that the presence of FJ [facet joint] inflammation is associated with higher odds for the development of subsequent FJA [facet joint ankylosis] at the same spinal location," the authors wrote.

SOURCE:

The study was led by Manouk de Hooge, PhD, Department of Rheumatology, Ghent University, Ghent, Belgium, and was published online on June 8, 2024, in RMD Open. 

LIMITATIONS:

One major limitation was the lack of involvement of a radiologist in the reading evaluation process. Furthermore, the study population consisted of older individuals with longstanding disease, which could affect the generalizability of the findings.

DISCLOSURES:

The study cohort was funded by "ReumaNederland" (Dutch Rheumatism Foundation). The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.