CHAPTER 10: Magnetic resonance imaging in axial spondyloarthritis 1: technique, basic lesions and differential diagnoses
Abstract
There are currently various imaging techniques used for both the diagnosis and monitoring of spondyloarthritis (SpA). Conventional radiography such as musculoskeletal ultrasound and magnetic resonance imaging (MRI) have multiple uses, although they also have limitations that must be taken into account in clinical practice. MRI, unlike conventional radiography, allows for early diagnosis. MRI is a high-resolution technique for assessing the various anatomical structures. It allows us to assess the involvement of this disease at the peripheral level as well as at the axial skeleton level, and with the use of different sequences, we can identify both lesions due to disease activity and lesions secondary to structural damage. Both lesions, both inflammatory and structural, are observed earlier in MRI than in conventional radiography.References
I. Oostveen J, Prevo R, den Boer J, van de Laar M. Early detection of sacroiliitis on magnetic resonance imaging and subsequent development of sacroiliitis on plain radiography. A prospective, longitudinal study. J Rheumatol 1999;26:1953-8.
II. Maksymowych WP, Wichuk S, Dougados M, Jones H, Szumski A, Bukowski JF, et al. Mri evidence of structural changes in the sacroiliac joints of patients with non-radiographic axial spondyloarthritis even in the absence of MRI inflammation. Arthritis Res Ther 2017;19.
III. Rudwaleit M, Jurik AG, Hermann KG, Landewé R, van der Heijde D, Baraliakos X, et al. 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 2009;68:1520-7.
IV. Maksymowych WP, Lambert RG, Østergaard M, Pedersen SJ, Machado PM, Weber U, et al. MRI lesions in the sacroiliac joints of patients with spondyloarthritis: an update of definitions and validation by the ASAS MRI working group. Ann Rheum Dis 2019;78(11):1550-1558
V. Lambert RG, Bakker PA, van der Heijde D, Weber U, Rudwaleit M, Hermann KG, et al. Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI Working group. Ann Rheum Dis 2016;75:1958-63.
VI. Maksymowych WP, Crowther SM, Dhillon SS, Conner-Spady B, Lambert RG. Systematic assessment of inflammation by magnetic resonance imaging in the posterior elements of the spine in ankylosing spondylitis. Arthritis Care & Research 2010;62(1):4-10.
VII. Merjanah S, Igoe A, Magrey M. Mimics of axial spondyloarthritis. Curr Opin Rheumatol. 2019;31(4):335-343.
VIII. Caetano AP, Mascarenhas VV, Machado PM. Axial spondyloarthritis: mimics and pitfalls of imaging assessment. Front Med (Lausanne). 2021 Apr 22;8:658538.
IX. Jurik AG. Diagnostics of sacroiliac joint differentials to axial spondyloarthritis changes by magnetic resonance imaging. J Clin Med. 2023 Jan 29;12(3):1039.
Copyright (c) 2024 on behalf of the authors. Reproduction rights: Argentine Society of Rheumatology
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
