Ankylosing spondylitis MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

MRI may be helpful in the diagnosis of ankylosing spondylitis. Findings on MRI suggestive of ankylosing spondylitis include sacroiliitis, disease activity,cartilage condition and enthesitis.MRI allows assessment of all of the structures that are involved in musculoskeletal diseases.MRI is more sensitive in inflammatory and degenerative rheumatological disorders.However, not all patients with nr-axSpA have abnormal MRI findings.

MRI Scan

  • Findings on MRI suggestive of ankylosing spondylitis include:[1][2][3][4][5][6][7]
    • Helps in diagnosis of active sacroiliitis.
    • Helps in diagnosis of enthesitis/ capsulitis.
    • Helps in detection of bone marrow edema (BME).
    • Helps in detection of fat metaplasia.
    • helps in detection of
      • Cartilage inflammation and destruction.
      • Bone erosions
      • Subchondral bone changes

References

  1. Lacout, Alexis; Rousselin, Benoît; Pelage, Jean-Pierre (2008). "CT and MRI of Spine and Sacroiliac Involvement in Spondyloarthropathy". American Journal of Roentgenology. 191 (4): 1016–1023. doi:10.2214/AJR.07.3446. ISSN 0361-803X.
  2. Ostergaard M, Lambert RG (August 2012). "Imaging in ankylosing spondylitis". Ther Adv Musculoskelet Dis. 4 (4): 301–11. doi:10.1177/1759720X11436240. PMC 3403247. PMID 22859929.
  3. Shih TT, Chen PQ, Li YW, Hsu CY (2001). "Spinal fractures and pseudoarthrosis complicating ankylosing spondylitis: MRI manifestation and clinical significance". J Comput Assist Tomogr. 25 (2): 164–70. PMID 11242208.
  4. Marzo-Ortega H, McGonagle D, O'Connor P, Hensor EM, Bennett AN, Green MJ, Emery P (November 2009). "Baseline and 1-year magnetic resonance imaging of the sacroiliac joint and lumbar spine in very early inflammatory back pain. Relationship between symptoms, HLA-B27 and disease extent and persistence". Ann. Rheum. Dis. 68 (11): 1721–7. doi:10.1136/ard.2008.097931. PMID 19019894.
  5. Weber U, Lambert RG, Østergaard M, Hodler J, Pedersen SJ, Maksymowych WP (October 2010). "The diagnostic utility of magnetic resonance imaging in spondylarthritis: an international multicenter evaluation of one hundred eighty-seven subjects". Arthritis Rheum. 62 (10): 3048–58. doi:10.1002/art.27571. PMID 20496416.
  6. Rudwaleit M, Jurik AG, Hermann KG, Landewé R, van der Heijde D, Baraliakos X, Marzo-Ortega H, Ostergaard M, Braun J, Sieper J (October 2009). "Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group". Ann. Rheum. Dis. 68 (10): 1520–7. doi:10.1136/ard.2009.110767. PMID 19454404.
  7. Lambert RG, Bakker PA, van der Heijde D, Weber U, Rudwaleit M, Hermann KG, Sieper J, Baraliakos X, Bennett A, Braun J, Burgos-Vargas R, Dougados M, Pedersen SJ, Jurik AG, Maksymowych WP, Marzo-Ortega H, Østergaard M, Poddubnyy D, Reijnierse M, van den Bosch F, van der Horst-Bruinsma I, Landewé R (November 2016). "Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group". Ann. Rheum. Dis. 75 (11): 1958–1963. doi:10.1136/annrheumdis-2015-208642. PMID 26768408.

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