Evaluation of the current use of MRI to aid the diagnosis of axial spondyloarthritis in the UK: results from a freedom of information request.

AIM: To evaluate the impact of recommendations from the 2019 consensus exercise conducted by radiologists and rheumatologists on the use of magnetic resonance imaging (MRI) to investigate axial spondyloarthritis (axSpA) in clinical practice. MATERIALS AND METHODS: A freedom of information (FOI) request was used to assess the use of MRI in the diagnosis of axSpA and radiologists' awareness of the 2019 guidance across all NHS Trusts and Health Boards in the UK, including England, Scotland, Northern Ireland, and Wales. RESULTS: The FOI request was sent to 150 Trusts/Health Boards, and 93 full responses were received. Of the 93 respondents (97%), 90 reported familiarity with the term axSpA and 70/93 (75%) reported familiarity with the 2019 recommendations. Awareness of recommendations regarding specific MRI features supportive of the diagnosis of axSpA was 74/93 (80%) for the sacroiliac joints (SIJs) and 66/93 (71%) for the spine. The median wait for MRI acquisition was 2-3 months. Fifty-two of the 93 (56%) reported at least some outsourcing of axSpA MRI (33%/29% for specialist/non-specialist outsourcing respectively); 32/93 (34%) reported some scans being reported in-house by non-musculoskeletal radiologists. CONCLUSION: There have been several positive developments in the understanding and use of MRI for the diagnosis of axSpA in the UK since the 2017 survey, although substantial scope for further improvement remains. Several new challenges have also emerged, including the increase in waiting times, reliance on outsourcing, and the reporting of MRI by non-musculoskeletal radiologists.

Assessment of the injuries sustained by pregnant sows housed in groups using electronic feeders.

The incidence of injuries to pregnant sows kept in dynamic groups in a commercial herd was recorded over a period of 18 months. The sows were maintained in a solid-floored building with a straw-bedded lying area allowing 1.7 m2 per sow and fed by means of electronic feeders. Injuries on 12 possible areas of the body were assessed every week, and graded on the scale of 0 to 3 (maximum body score 36). The lesion scores sustained by the sows were very low, with a maximum of 19 and a median of 4. Lesions of the greatest severity constituted only 0.16 per cent of all the recorded injuries. The injuries were not distributed uniformly over the body, most being on the shoulders, flanks and hindquarters, with very few on the head or in the vulval region. The total injury score was related to parity, with sows in parities one, two and three sustaining more injuries than sows in later parities, and it was also related negatively to bodyweight. More agonistic interactions were observed between sows in the lying area and in the vicinity of the feeders than in the dunging area.