MRI in seronegative spondyloarthritis: imaging features and differential diagnosis in the spine and sacroiliac joints.
ABSTRACT OBJECTIVE: 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. CONCLUSION: 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.
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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
Article: Imaging of Spondyloarthropathies.[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 · 1.74 Impact Factor
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ABSTRACT: Seronegative spondyloarthropathy is a group of chronic inflammatory rheumatic diseases that predominantly affect the axial skeleton. Involvement of sacroiliac joint is considered a hallmark for diagnosis of seronegative spondyloarthropathy and is usually the first manifestation of this condition. It is essential for the radiologist to know the computed tomography (CT) and magnetic resonance imaging (MRI) features of spondyloarthropathy-related sacroiliitis as imaging plays an important role in diagnosis and evaluation of response to treatment. We present a pictorial essay of CT and MRI imaging findings in seronegative spondyloarthropathy-related sacroiliitis in various stages and highlight common differentials that need to be considered.Indian Journal of Radiology and Imaging 07/2014; 24(3):271-8. DOI:10.4103/0971-3026.137046