Radiologists should be familiar with MRI findings suggestive of spondyloarthritis and its differential diagnosis. Because most publications describing these features are found in the rheumatologic literature, the purpose of this review is to present these imaging findings of axial spondyloarthritis to radiologists.
New imaging outcomes have improved the diagnosis and follow-up of spondyloarthritis and the assessment of therapeutic modalities. Diagnostic criteria include MRI of the sacroiliac joint, which facilitates earlier diagnosis.
[Show abstract][Hide abstract] ABSTRACT: Spondyloarthropathies belong to a group of rheumatic diseases, in which inflammatory changes affect mainly the sacroiliac joints, spine, peripheral joints, tendon, ligaments and capsule attachments (entheses). This group includes 6 entities: ankylosing spondylitis, arthritis associated with inflammatory bowel disease, reactive arthritis, undifferentiated spondyloarthropathy, psoriatic arthritis and juvenile spondyloarthropathy.
In 2009, ASAS (Assessment in SpondyloArthritis international Society) association, published classification criteria for spondyloarthropathies, which propose standardization of clinical-diagnostic approach in the case of sacroiliitis, spondylitis and arthritis.
Radiological diagnosis of inflammatory changes of sacroiliac joints is based on a 4 step radiographic grading method from 1966. According to modified New York criteria, the diagnosis of ankylosing spondylitis is made based on the presence of advanced lesions, sacroiliitis of at least 2 grade bilaterally or 3–4 unilaterally. In case of other types of spondyloarthropathies diagnosis is made based on presence of at least grade 1 changes.
In MRI, active inflammation of sacroiliac joints is indicated by the presence of subchondral bone marrow edema, synovitis, bursitis, or enthesitis.
ASAS discusses only the classic form of axial spondyloarthropathies, which is ankylosing spondylitis. To quantify radiological inflammatory changes in the course of the disease, Stoke Ankylosing spondylitis classification Spinal Score (SASSS) is recommended. The signs of inflammation and scarrying of the spinal cord in the course of ankylosing spondylitis, present in MRI include: bone marrow edema, sclerosis, fat metaplasia, formation of syndesmophytes, and ankylosis.
Polish Journal of Radiology 04/2013; 78(2):43-49. DOI:10.12659/PJR.889039
[Show abstract][Hide abstract] ABSTRACT: Spondyloarthropathies (SpA) are a group of disorders that primarily affect the synovial joints of the axial and appendicular skeleton of variable predilections. Plain radiography is the initial and standard method of investigation in axial SpAs. Careful evaluation of the radiographs through developing a systematic approach is indispensible in reaching the correct diagnosis. Cross-sectional imaging, in particular magnetic resonance imaging, has been increasingly used in evaluating SpAs during the early phases of the disease or when radiographic findings are equivocal. Different types of SpAs demonstrate different imaging characteristics that are important to identify to reach the correct diagnosis.
Rheumatic diseases clinics of North America 08/2013; 39(3):645-667. DOI:10.1016/j.rdc.2013.02.005 · 2.69 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The spine and sacroiliac joint are involved in most cases of axial spondyloarthritis. Several pathologic findings from a radiography involving the spine and sacroiliac joint are the diagnostic hallmarks of axial spondyloarthritis. However, these radiographic changes reflect structural damage rather than active inflammation, which may delay diagnosis by several years. Nowadays, the Assessment of SpondyloArthritis international Society (ASAS) has focused on the reassessment of existing classification criteria and the development and validation of diagnostic tools to facilitate early diagnosis and assessment of treatment response. Magnetic resonance (MR) findings are the most remarkable changes with respect to the previously established classification criteria. Familiarity with typical MRI findings of axial spondyloarthritis and differential diseases is important in order to correctly interpret the findings and avoid misdiagnosis.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.