Detection of radiographic sacroiliitis with an artificial neural network in patients with suspicion of axial spondyloarthritis

Dear Editor, Conventional radiography of the SI joints is still recommended as the first imaging method for the diagnosis of axial SpA (axSpA) [1]. In many clinical settings around the world this is the only widely available imaging method to diagnose axSpA. In the analysis of the DESIR cohort, a significant proportion of patients with radiographic sacroiliitis that was obvious according to the local reader (41.5% for unilateral, 29.4% for bilateral) were considered as ‘negative’ by experienced trained readers (false-positive calls), while the proportion of false-negative calls was substantially lower [2]. This fact has large clinical implications, since the presence of definite radiographic sacroiliitis (usually defined as ≥grade 2 bilaterally or ≥grade 3 unilaterally according to the modified New York criteria [3]) is often considered as confirmation of the diagnosis of axSpA with subsequent application of axSpA-specific treatments. The absence of radiographic sacroiliitis...