Download PDF
Semin Musculoskelet Radiol 2012; 16(05): 389-400
DOI: 10.1055/s-0032-1329882
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Advanced Imaging of the Axial Skeleton in Spondyloarthropathy: Techniques, Interpretation, and Utility

Robert G.W. Lambert
1   Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, Alberta, Canada
,
Sukhvinder S. Dhillon
1   Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, Alberta, Canada
,
Jacob L. Jaremko
1   Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, Alberta, Canada
› Author Affiliations
Further Information

Publication History

Publication Date:
04 December 2012 (online)

Also available at
    Permissions and Reprints

Abstract

The development of available treatments for spondyloarthritis increases the need for accurate diagnosis and objective monitoring of response to therapy. Advances in MRI technology are improving the effectiveness of imaging of the sacroiliac joints and spine in spondyloarthritis. We discuss best practice techniques for MR image acquisition and interpretation with a view to optimizing the diagnostic utility of MRI in spondyloarthritis.

Keywords

spondyloarthritis - MRI - sacroiliitis - protocol - diagnostic utility
 

  • References

  • 1 Ma J. Dixon techniques for water and fat imaging. J Magn Reson Imaging 2008; 28 (3) 543-558
    CrossrefPubMedSearch in Google Scholar
  • 2 Ai F, Ai T, Li X, Hu D, Zhang W, Morelli JN. Value of diffusion-weighted magnetic resonance imaging in early diagnosis of ankylosing spondylitis. Rheumatol Int 2012; ; January 3 (Epub ahead of print)
    PubMedSearch in Google Scholar
  • 3 Gong Y, Zheng N, Chen SB , et al. Ten years' experience with needle biopsy in the early diagnosis of sacroiliitis. Arthritis Rheum 2012; 64 (5) 1399-1406
    CrossrefPubMedSearch in Google Scholar
  • 4 Algin O, Gokalp G, Ocakoglu G. Evaluation of bone cortex and cartilage of spondyloarthropathic sacroiliac joint: efficiency of different fat-saturated MRI sequences (T1-weighted, 3D-FLASH, and 3D-DESS). Acad Radiol 2010; 17 (10) 1292-1298
    CrossrefPubMedSearch in Google Scholar
  • 5 Madsen KB, Egund N, Jurik AG. Grading of inflammatory disease activity in the sacroiliac joints with magnetic resonance imaging: comparison between short-tau inversion recovery and gadolinium contrast-enhanced sequences. J Rheumatol 2010; 37 (2) 393-400
    CrossrefPubMedSearch in Google Scholar
  • 6 Baraliakos X, Hermann KG, Landewé R , et al. Assessment of acute spinal inflammation in patients with ankylosing spondylitis by magnetic resonance imaging: a comparison between contrast enhanced T1 and short tau inversion recovery (STIR) sequences. Ann Rheum Dis 2005; 64 (8) 1141-1144
    CrossrefPubMedSearch in Google Scholar
  • 7 Rudwaleit M, Jurik AG, Hermann KG , 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 (10) 1520-1527
    CrossrefPubMedSearch in Google Scholar
  • 8 Puhakka KB, Melsen F, Jurik AG, Boel LW, Vesterby A, Egund N. MR imaging of the normal sacroiliac joint with correlation to histology. Skeletal Radiol 2004; 33 (1) 15-28
    CrossrefPubMedSearch in Google Scholar
  • 9 Weber U, Pedersen SJ, Ostergaard M, Rufibach K, Lambert RG, Maksymowych WP. Can erosions on MRI of the sacroiliac joints be reliably detected in patients with ankylosing spondylitis? A cross-sectional study. Arthritis Res Ther 2012; 14 (3) R124
    CrossrefPubMedSearch in Google Scholar
  • 10 Weber U, Pedersen SJ, Hodler J, Østergaard M, Lambert RGW, Maksymowych WP. Does fat infiltration in the sacroiliac joint contribute to the diagnostic utility of MRI in ankylosing spondylitis?. Arthritis Rheum 2009; 60 (Suppl. 10) 54
    PubMedSearch in Google Scholar
  • 11 Østergaard M, Maksymowych WP, Pedersen SJ, Chiowchanwisawakit P, Lambert RGW. Structural lesions detected by magnetic resonance imaging in the spine of patients with spondyloarthritis—definitions, assessment system, and reference image set. J Rheumatol 2009; 36: 18-34
    PubMedSearch in Google Scholar
  • 12 Lambert RG, Pedersen SJ, Maksymowych WP, Chiowchanwisawakit P, Ostergaard M. Active inflammatory lesions detected by magnetic resonance imaging in the spine of patients with spondyloarthritis—definitions, assessment system, and reference image set. J Rheumatol Suppl 2009; 36: 3-17
    PubMedSearch in Google Scholar
  • 13 Rennie WJ, Dhillon SS, Conner-Spady B , et al. Magnetic resonance imaging assessment of spinal inflammation in ankylosing spondylitis: standard clinical protocols may omit inflammatory lesions in thoracic vertebrae. Arthritis Rheum 2009; 61 (9) 1187-1193
    CrossrefPubMedSearch in Google Scholar
  • 14 Maksymowych WP, Crowther SM, Dhillon SS , et al. Systematic assessment of inflammation by magnetic resonance imaging in the posterior elements of the spine in ankylosing spondylitis. Arthritis Care Res 2010; 62 (1) 4-10
    CrossrefPubMedSearch in Google Scholar
  • 15 van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 1984; 27 (4) 361-368
    CrossrefPubMedSearch in Google Scholar
  • 16 Mau W, Zeidler H, Mau R , et al. Clinical features and prognosis of patients with possible ankylosing spondylitis. Results of a 10-year followup. J Rheumatol 1988; 15 (7) 1109-1114
    PubMedSearch in Google Scholar
  • 17 Rudwaleit M, Haibel H, Baraliakos X , et al. The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Rheum 2009; 60 (3) 717-727
    CrossrefPubMedSearch in Google Scholar
  • 18 Bennett AN, McGonagle D, O'Connor P , et al. Severity of baseline magnetic resonance imaging-evident sacroiliitis and HLA-B27 status in early inflammatory back pain predict radiographically evident ankylosing spondylitis at eight years. Arthritis Rheum 2008; 58 (11) 3413-3418
    CrossrefPubMedSearch in Google Scholar
  • 19 Haibel H, Rudwaleit M, Listing J , et al. Efficacy of adalimumab in the treatment of axial spondylarthritis without radiographically defined sacroiliitis: results of a twelve-week randomized, double-blind, placebo-controlled trial followed by an open-label extension up to week fifty-two. Arthritis Rheum 2008; 58 (7) 1981-1991
    CrossrefPubMedSearch in Google Scholar
  • 20 Bollow M, Hermann KG, Biedermann T, Sieper J, Schöntube M, Braun J. Very early spondyloarthritis: where the inflammation in the sacroiliac joints starts. Ann Rheum Dis 2005; 64 (11) 1644-1646
    CrossrefPubMedSearch in Google Scholar
  • 21 Weber U, Pfirrmann CW, Kissling RO, Mackenzie CR, Khan MA. Early spondyloarthritis in an HLA-B27-positive monozygotic twin pair: a highly concordant onset, sites of involvement, and disease course. J Rheumatol 2008; 35 (7) 1464-1466
    PubMedSearch in Google Scholar
  • 22 Rudwaleit M, van der Heijde D, Landewé R , et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 2009; 68 (6) 777-783
    CrossrefPubMedSearch in Google Scholar
  • 23 Arnbak B, Leboeuf-Yde C, Jensen TS. A systematic critical review on MRI in spondyloarthritis. Arthritis Res Ther 2012; 14 (2) R55
    CrossrefPubMedSearch in Google Scholar
  • 24 Weber U, Lambert RG, Østergaard M, Hodler J, Pedersen SJ, Maksymowych WP. The diagnostic utility of magnetic resonance imaging in spondylarthritis: an international multicenter evaluation of one hundred eighty-seven subjects. Arthritis Rheum 2010; 62 (10) 3048-3058
    CrossrefPubMedSearch in Google Scholar
  • 25 Weber U, Hodler J, Kubik RA , et al. Sensitivity and specificity of spinal inflammatory lesions assessed by whole-body magnetic resonance imaging in patients with ankylosing spondylitis or recent-onset inflammatory back pain. Arthritis Rheum 2009; 61 (7) 900-908
    CrossrefPubMedSearch in Google Scholar
  • 26 Bennett AN, Rehman A, Hensor EM, Marzo-Ortega H, Emery P, McGonagle D. Evaluation of the diagnostic utility of spinal magnetic resonance imaging in axial spondylarthritis. Arthritis Rheum 2009; 60 (5) 1331-1341
    CrossrefPubMedSearch in Google Scholar
  • 27 Bennett AN, Rehman A, Hensor EM, Marzo-Ortega H, Emery P, McGonagle D. The fatty Romanus lesion: a non-inflammatory spinal MRI lesion specific for axial spondyloarthropathy. Ann Rheum Dis 2010; 69 (5) 891-894
    CrossrefPubMedSearch in Google Scholar