Compatibility of the rheumatologist's sacroiliac joint evaluation and the findings in the radiologist's report in spondyloarthritis patients who received abdomen computed tomography for any reason

Introduction: When abdominal computed tomography (CT) is performed for patients with a diagnosis of spondyloarthritis (SpA), suspected acute abdomen, malignancy injuries or nephrolithiasis, a primary target-oriented report can be written by the radiologist and changes in the sacroiliac joint (SIE) are not reported. In this study, we aimed to retrospectively analyze the sacroiliac joint imaging of patients with SpA who had an abdominal CT for any reason, and to check the consistency with the radiologist's report in terms of the presence of sacroillitis. Materials and Methods: 188 patients who were diagnosed as SpA in Dokuz Eylul University Hospital Rheumatology outpatient clinic and who had at least one abdominal CT for any reason were included in the study. Comorbidities, clinical findings in the follow-up, laboratory data and drug use of the patients were evaluated. Pelvis direct radiographs were evaluated independently by two separate rheumatologists. Abdominal CTs were examined by a rheumatologist for the presence of fusion, apparent change, and by calculating the total erosion score. These data were compared with sacroiliitis data in abdominal CT radiology official reports in the hospital system. Results: When CT reports were examined, there were findings consistent with sacroiliitis in 33 patients, while sacroiliitis was not reported in 155 patients. When the images were re-evaluated, structural changes consistent with sacroiliitis were detected in 82 patients. Sacroillitis was reported in only 23 (28%) of these patients with structural changes on CT. While there was sacroiliitis in the radiology report of 10 (9.4%) patients (106 patients) without structural changes on CT, there was no sacroiliitis in the radiology report of 96 patients (90.6%) (p<0.001). In the re-examined CTs, the apparent change/fusion rates were 75.8% in the group with sacroiliitis finding in the radiology report, while it was 34.2% in the group without sacroiliitis in the radiology report (p<0.001). While sacroiliitis was reported in the radiology report in 30.8% (16 patients) of patients with total fusion, sacroiliitis was reported in only 12.5% (17 patients) of patients without total fusion (p=0.003). Conclusion: Our study is the first in the literature in which the images of patients diagnosed with SpA who underwent abdominal CT for any reason were re-evaluate by rheumatologists and compared with radiology reports. While structural changes consistent with sacroiliitis werw detected 82 patients in the study, sacroiliitis was reported in only 23 (%28) patients with structural changes on CT. This situation seems to be caused by the high report burden per physician and the evaluation of the findings only in response to the reason for the examination request. Keywords: Spondyloarthritis, sacroiliitis, computed tomography, erosion