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Étude en IRM des sacro iliaques chez les femmes atteintes de spondylarthrite axiale : impact du statut HLA B27, de la durée d’évolution de la maladie, et comparaison à une population non atteinte
Mémoire de Master / Thèse d'exercice

Étude en IRM des sacro iliaques chez les femmes atteintes de spondylarthrite axiale : impact du statut HLA B27, de la durée d’évolution de la maladie, et comparaison à une population non atteinte

Jean-Baptiste Gourragne
Masters , Université de Montpellier
25/10/2024

Résumé

Bone marrow edema Fatty metaplasia lesions Sacro iliac Spondyloarthritis HLA B27 HLA B27 Œdème de moelle osseuse Lésions de métaplasie graisseuse Sacro iliaques Spondylarthrite Inflammation
Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease primarily affecting young adults and characterized by a genetic predisposition associated with the HLA B27 antigen. The aim of this study is to assess the relationship between HLA B27 status and inflammatory and fatty lesions of the sacroiliac joints (SIJ) in a female population with axial SpA, and to evaluate the correlation between HLA B27 status and the size of the lesions. Methods: this retrospective monocentric study included 209 female patients with axSpA, divided into two groups: HLA B27 positive (n=119) and HLA B27 negative (n=90). SIJ MRIs were analyzed to identify the presence of inflammatory and fatty lesions, and their volumes were measured. The results were adjusted based on the duration of disease progression. Results: there was no significant difference between the two groups regarding the presence of SIJ lesions (inflammatory and fatty) (p=0.393), nor in the volume of the lesions, even after adjustment for the duration of disease progression (p=0.335). In the univariate model, HLA B27-negative women had proportionally more inflammatory lesions than HLA B27-positive women, but this difference was not significant after adjustment for the disease progression duration. Conclusion: these results suggest that HLA B27 status does not appear to influence the quantity or extent of inflammatory and fatty lesions in women with axSpA. Therefore, knowledge of HLA B27 status should not affect the radiologist's interpretation of SIJ MRIs. Further research is needed, particularly to assess the specificity and timing of different axSpA manifestations within the female population.

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