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Joint Bone Spine
Volume 83, n° 2
pages 179-183 (mars 2016)
Doi : 10.1016/j.jbspin.2015.05.011
accepted : 5 May 2015
Backfill is a specific sign of axial spondyloarthritis seen on MRI

Zaiying Hu a, Xiaohong Wang b, Jun Qi a, QingCong Kong b, Minjing Zhao a, Jieruo Gu a,
a Department of rheumatology, the third affiliated hospital, Sun Yat-Sen university, 600, Tianhe Road, 510630 Guangzhou, China 
b Department of radiology, the third affiliated hospital, Sun Yat-Sen university, 600, Tianhe Road, 510630 Guangzhou, China 

Corresponding author.

To summarize the characteristics of backfill in patients with axial spondyloarthritis (SpA) and patients with non-specific back pain (NSBP) and healthy controls, and to assess the value of backfill in diagnosing axial SpA.


Three readers blinded recorded backfill seen on T1SE MRI scans from 647 subjects: 297 patients with ankylosing spondylitis (AS), 126 patients with non-radiographic axial SpA (nr-axSpA), 147 patients with NSBP, and 77 healthy controls. The SPARCC SIJ Structural Score (SSS) method was used to assess backfill. The changes of backfill were evaluated by the follow-up MRI scans from 157 patients. We summarized the characteristics of backfill and calculated its sensitivity and specificity for diagnosing axial SpA.


Backfill was recorded in 78.8% AS patients, 11.1% nr-axSpA patients, 1.8% patients with NSBP, and no healthy control. Backfill affected more frequently at ilium bone, lower half of sacroiliac joints in axial SpA (both P <0.05). The SSS score of backfill was much higher in axial SpA than in patients with NSBP (both P <0.01) and it did not correlate with demographics and BASDAI, BASFI, and CRP (all P >0.05). The score of backfill only positively correlated with symptom duration in AS (r =0.251, P <0.01) and in nr-axSpA (r =0.743, P <0.01) patients. Only 8.9% patients had the change of backfill in an average follow-up time of 1.09 years. Backfill had high specificity (0.98) and moderate sensitivity (0.59) for diagnosing axial SpA.


We summarized the characteristics of backfill and found that backfill is a specific sign of axial SpA seen on T1SE MRI.

The full text of this article is available in PDF format.

Keywords : Spondyloarthritis, MRI

© 2015  Published by Elsevier Masson SAS.
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