The many faces of Ankylosing Spondylitis on MRI- a practical guide for young radiologists

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2017

Poster Number:

C-1795

Type:

Educational Exhibit

Keywords:

Musculoskeletal spine, Pelvis, Musculoskeletal joint, MR, Diagnostic procedure, Computer Applications-Detection, diagnosis, Inflammation, Arthritides, Acute

Authors:

R. E. Coroiu¹, A. M. Calin², M.-M. Tamas³; ¹Cluj /RO, ²Cluj-Napoca/RO, ³Cluj/RO

DOI:

10.1594/ecr2017/C-1795

DOI-Link:

https://dx.doi.org/10.1594/ecr2017/C-1795

Table 1: The modified New York criteria for ankylosing spondylitis

Table 2: The ASAS classification criteria for axial and peripheral spondyloarthritis

Fig. 3: AP and LL spine radiography of a patient with Andersson lesion at the level of...

Fig. 2: AP and LL spine radiography views of a patient with Romanus lesions

Learning objectives

To describe the radiological signs of axial spondylarthritis (AxSpA) and non-radiographic axial spondylarthritis (nrAxSpA) and to correlate clinical and pathological features, in order to recognize the early stages of the diseases. To provide a review and update of the contemporary role of imaging in the assessment of the ankylosing spondylitis, with a focus on radiographs and magnetic resonance (MR) imaging.

Background

The term non-radiographic axial spondylarthritis (nrAxSpA) is referring to patients suffering from the early phase of ankylosing spondylitis (AS). These patients presenting with a clinical picture suspicious for AS but who haven’t yet developed radiographic sacroiliitis, would be diagnosed today as having nrAxSpA based on magnetic resonance imaging (MRI) and a composite of clinical manifestations.[1] Among rheumatologic diseases arthritis is the leading cause of disability in adults. Radiologists are most familiar with diagnostic criteria, which can be defined as a set of symptoms, signs and...

Findings and procedure details

In general, for the diagnosis of axSpA, radiography is the first-line imaging modality. Anteroposterior and lateral views of the entire spine, as well as an erect anteroposterior view of the pelvis, should be obtained to evaluate both the sacroiliac joints and the hips (oblique sacroiliac joint views are not necessary). Although the sacroiliac joints are the most important joints to image because the disease nearly always starts in this location of the axial skeleton, radiographs of the spine in the same setting can be useful...

Conclusion

Developments and improvements in knowledge are rapid and ongoing in both the radiologic and rheumatologic fields. During the past decade, in particular, many changes have occurred with regard to the roles of imaging and the radiologist in the assessment and management of the ankylosing spondylitis. Familiarity with classification criteria, in addition to the traditional diagnostic characteristics of the disease, allows for a more productive interface between the radiologist and the rheumatologist. The goal of contemporary Ankylosing Spondylitis (AS) management is to redefine AS as a...

Personal information

References

[1] Eric Y. Chang, MD Karen C. Chen, MD Brady K. Huang, MD Arthur Kavanaugh, MD. Adult Inflammatory Arthritides: What the radiologist should know. RadioGraphics 2016; 36:1849–1870 [2] Ruben Burgos-Vargas, James Cheng-Chung Wei, Mahboob U. Rahman et al. The prevalence and clinical characteristics of nonradiographic axial spondyloarthritis among patients with inflammatory back pain in rheumatology practices: a multinational, multicenter study. Arthritis Research & Therapy (2016) 18:132 [3] X Baraliakos, J Braun. Non-radiographic axial spondyloarthritis and ankylosing spondylitis: what are the similarities and differences? RMD Open...