The Correlation of MRI Findings in Newly Diagnosed Axial Spondyloarthritis with the Practiced Subjective Patient-Reported Disease Activity Scores

Objective: The objective of the study was to evaluate the correlation between magnetic resonance imaging (MRI) findings and patient-reported disease activity scores – bath ankylosing spondylitis disease activity index (BASDAI), ankylosing spondylitis disease activity score (ASDAS) based on erythrocyte sedimentation rate (ASDAS-ESR), and C-reactive protein (ASDAS-CRP) – in patients with newly diagnosed axial spondyloarthritis (axSpA). Materials and Methods: A retrospective cross-sectional study was conducted at the Rheumatology Clinics of King Saud University Medical City. Forty-one patients with a confirmed diagnosis of axSpA based on MRI were included in the study. All participants completed BASDAI and ASDAS assessments within 1 year before imaging. MRI scans were reviewed for sacroiliitis and patterns of involvement. Correlations between imaging findings and disease activity scores were analyzed using the Statistical Package for the Social Sciences. Results: Active sacroiliitis was observed in 82.9% of patients, with 80.5% demonstrating bilateral lateral joint involvement on MRI. However, no statistically significant correlation was found between MRI findings and BASDAI, ASDAS-ESR, or ASDAS-CRP scores ( P value ranging from 0.059 to 0.925). These results suggest a discrepancy between objective imaging and subjective clinical assessments. Conclusion: The absence of significant correlation between MRI-detected inflammation and patient-reported disease activity highlights the limitations of relying solely on subjective scoring tools in axSpA assessment. A multidimensional approach incorporating both clinical indices and imaging findings is essential for accurate disease evaluation and management.