ankylosing spondylitis cervical spine x ray

#Ankylosing spondylitis cervical spine x ray update#
#Ankylosing spondylitis cervical spine x ray full#

Being familiar with the main imaging findings and terminology of axSpA ( Table 1) as well as knowing the topographic distribution of common and uncommon conditions involving the SIJ is key to establishing a confident diagnosis ( Figures 1A,B). MRI evaluation of the SIJ can be quite challenging even for experienced radiologists, due to several pitfalls.

#Ankylosing spondylitis cervical spine x ray full#

Importantly, the full range and combination of active and structural lesions of the SIJ and spine should be taken into account when deciding if the MRI scan is suggestive of axSpA or not (i.e., contextual interpretation of active and structural lesions is key to enhancing diagnostic utility of MRI in patients with suspected axSpA), as imaging cannot be viewed in isolation and needs to be interpreted in the light of clinical presentation and results of laboratory investigations ( 4, 5). The new consensus definitions for MRI lesions in the spine will replace a previous consensus manuscript by the same group ( 3). A similar exercise has been conducted for spine lesions and recently published in abstract format ( 2). Multi-reader validation performed by the working group demonstrated substantial reliability for the most frequently detected lesions and comparable reliability between active and structural lesions.

#Ankylosing spondylitis cervical spine x ray update#

The Assessment of Spondyloarthritis International Society (ASAS) MRI working group has recently generated a consensus update on standardized definitions for MRI lesions in the sacroiliac joint (SIJ) of patients with axSpA ( 1). In recent years, the introduction of MRI into clinical practice has facilitated earlier diagnosis of axSpA, and therefore earlier initiation of appropriate treatment. Computed tomography (CT) allows for detection of smaller structural lesions in patients with chronic sacroiliitis that would otherwise be invisible on conventional radiography, thus aiding in the diagnostic work up of axSpA. Historically, the diagnosis of axSpA has often been delayed since radiographic abnormalities may take years to develop. This group includes patients with radiographic axSpA, with established sacroiliitis on radiographs, and a further subgroup called non-radiographic axSpA, who typically have evidence of sacroiliitis on magnetic resonance imaging (MRI) in the absence of definite radiographic changes. This review outlines the imaging evaluation of axSpA with a focus on imaging mimics and potential pitfalls when assessing the axial skeleton.Īxial spondyloarthritis (axSpA) is an umbrella term encompassing a group of chronic immune-mediated inflammatory diseases of the axial skeleton. Conventional radiography, on the other hand, has limitations, but it is easily accessible and may provide insight on gross changes as well as rule out other pathological features of the axial skeleton. However, bone structural changes are more accurately depicted using computed tomography. MRI also allows the detection of structural changes in the subchondral bone marrow that are not visible on conventional radiography and is of prognostic and monitoring value. Diagnosis may be challenging, particularly in early-stage disease and magnetic resonance imaging (MRI) plays a key role in the detection of subtle or inflammatory changes. The ability to distinguish between imaging lesions suggestive of axSpA and artifacts or lesions suggestive of other disorders is critical for the accurate diagnosis of axSpA. Imaging findings of axSpA can be divided into active changes, which include bone marrow edema, synovitis, enthesitis, capsulitis, and intra-articular effusion, and structural changes, which include erosions, sclerosis, bone fatty infiltration, fat deposition in an erosion cavity, and bone bridging or ankylosis.

6Department of Rheumatology, London North West University Healthcare National Health Service Trust, London, United KingdomĪxial spondyloarthritis (axSpA) is a chronic inflammatory disorder that predominantly involves the axial skeleton.

5National Institute for Health Research (NIHR) Biomedical Research Centre, University College London Hospitals National Health Service Foundation Trust, London, United Kingdom.4Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, United Kingdom.3EpiDoC Unit, Chronic Diseases Research Centre, NOVA Medical School, Lisbon, Portugal.2Musculoskeletal Imaging Unit, Grupo Luz Saúde, Radiology Department, Imaging Center, Hospital da Luz, Lisbon, Portugal.1Radiology Department, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal.