![]() ![]() 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.Read more about Ankylosing Spondylitis Diagnosis on Arthritis-health.António Proença Caetano 1 † Vasco V. Spondylitis Association of America web site. For example, most people with ankylosing spondylitis carry a gene called HLA-B27, so detecting it can be helpful to confirm a diagnosis when symptoms are already present.ġ Overview of ankylosing spondylitis. These tests can screen for inflammatory markers and genetic risk factors, which could indicate a higher likelihood of having ankylosing spondylitis. Other methods to view the spine may catch changes from ankylosing spondylitis sooner-such as MRI or CT scans-but they are also more expensive. However, sometimes an x-ray cannot pick up these changes in the sacroiliac joint until years after the symptoms have started. An xray image that shows in the sacroiliac joint(connecting lower spine and pelvis) has traditionally been a key factor in diagnosing ankylosing spondylitis. ![]()
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