The characteristic feature of axial spondyloarthropathy is inflammatory back pain due to sacroiliitis. However, there are other presentations including enthesitis, anterior chest wall, shoulder and hip involvement and non sacroiliac joint spinal pain which can be the presenting feature for the disease. In this poster, we show pictorial examples of non-characteristic first presentations of spondyloarthropathy to help the radiologist recognise the wide spectrum of imaging features which exist in spondyloarthropathy and allow them to raise the possibility of the diagnosis and possible need for further...

Spondyloarthritis encompasses a number of inflammatory conditions with some shared common features. Spondyloarthropathies are broadly divided into those predominantly affecting the axial skeleton, which will be our focus for this exhibit and those with a peripheral skeletal predominance. Spondyloarthritis has a reported prevalance of 0.8%-1.7% in Western Europe and is more common than rheumatoid arthritis (1). Despite this, prompt diagnosis of spondyloarthritis remains an ongoing challenge. Several studies have demonstrated a mean diagnostic dealy of axial spondyloarthropathy ranging from 2-8 years, with one study showing...

Imaging plays an important part in not only the diagnosis but also in the management of patients with spondyloarthropathy. As, is demonstrated in the multiple pictorial examples there are characteristic MRI findings which should prompt the radiologist to raise the concern for spondyloarthropathy. MRI is more sensitive when compared to radiographs and also allows soft tissue visualisation. Radiographs, however still play an important part especially when assessing disease progression. Computed tomography is also sensitive in assessing for structural change within the spine and sacroiliac joints...

Patients with axial spondyloarthropathy can present with non characteristic symptoms and signs which can result in generic rather then spondyloarthropathy focused imaging protocols. However, we hope that after reviewing this poster the radiologist will keep the diagnosis of axial spondyloarthropathy in their mind when reviewing any imaging of the axial or proximal appendicular skeleton. If they are then concerned regarding spondyloarthropathy, focused imaging should be performed. We hope this will reduce the imaging related diagnostic delay and help initiate correct patinet treatment and improve the...

National Institute for Health and Care Excellence (2017) Spondyloarthritis in over 16s: diagnosis and management (NICE Guideline 65. Available at:https://www.nice.org.uk/guidance/ng65/documents/spondyloarthritis-final-scope2 Ghosh N, Ruderman EM. Nonradiographic axial spondyloarthritis: clinical and therapeutic relevance.Arthritis Res Ther. 2017 Dec 22;19(1):286. doi: 10.1186/s13075-017-1493-8. PubMed PMID: 29273055; PubMed Central PMCID: PMC5741895. Hammoudeh M, Abdulaziz S, Alosaimi H, Al-Rayes H, Aldeen Sarakbi H, Baamer M, Baraliakos X, Dahou Makhloufi C, Janoudi N, Shirazy K, Sieper J, Sukhbir U. Challenges of diagnosis and management of axial spondyloarthritis in North Africa and the Middle...

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