Keywords:
Outcomes, Education and training, Imaging sequences, Education, MR, Conventional radiography, Musculoskeletal system, Musculoskeletal spine, Musculoskeletal joint
Authors:
M. Haris1, H. Gupta2; 1Halifax/UK, 2Leeds/UK
DOI:
10.26044/essr2019/P-0080
Imaging findings OR Procedure Details
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 however its use is limited due to ionising radiation especially in the younger age group.
Further difficulty and diagnostic delay arises when patients do not present with typical or characteristic clinical features which can lead to falsely re-assuring radiographs or CT imaging.
Also,
in the absence of a relevant history the reporter may be hesitant to suggest the diagnosis without appropriate clinical specialist input such as a rheumatologist.
Our local MRI protocol for sacroiliac joint imaging compromises of:
- Localiser of the cervical and thoracic spine
- Localiser of the lumbar spine
- STIR saggital to cover C7-L1
- T2 Fat Sat saggital lumbar spine
- Localiser of the pelvis
- T1 coronal oblique through the sacroiliac joints (angled to sacrum)
- T2 Fat Sat coronal oblique
- T2 Fat Sat axial pelvis