Better communication between rheumatologists and radiologists is key to improving MRI requesting and reporting data...

The assessment of axial spondyloarthritis international society (ASAS) has published recommendations on information to include when requesting and reporting MRIs for suspected or known axSpA. In a service improvement evaluation, we aimed to audit our current practice against the newly published recommendations.

MRIs of the spine and sacroiliac joints performed under the inflammatory back pain protocol at The Leeds Teaching Hospitals NHS Trust between September and December 2023 were identified. Information included in the MRI request and radiology reports was extracted from the electronic health records.

Overall, 158 MRIs were evaluated. Of the MRI requests, age was included in 11.8% (n = 18), sex in 3.8% (n = 6); HLA-B27 in 22.2% (n = 35), back pain symptom duration in 18.9% (n = 30) and location in 45.6% (n = 72) and presence of inflammatory features in 62.7% (n = 99). For MRI report data: osteitis/bone marrow oedema was mentioned in 81.0% (n = 128), erosions in 58.8% (n = 93) and fat metaplasia in 6.3% (n = 10); active inflammation was mentioned in 77.8% (n = 123) and structural changes in 51.2% reports (n = 82). Over half (62.0%; n = 98) included a statement as to "whether the MRI was overall indicative of spondyloarthritis or not".

Despite the retrospective nature of this audit performed against newly published guidance, these results provide awareness, identifying key areas in need of improvement at our centre. Further, this exercise has strengthened the collaboration between rheumatologists and radiology colleagues, illustrating the value of the recent ASAS recommendations as a benchmark to guide further training and education for rheumatologists and radiologists, and improve clinical care provision in axSpA.