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Semin Musculoskelet Radiol 2018; 22(02): 180-188
DOI: 10.1055/s-0038-1639470
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Sacroiliitis in Axial Spondyloarthritis: Assessing Morphology and Activity

Lennart Jans
1   Ghent University Hospital, Gent, Belgium
,
Niels Egund
2   Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
,
Iris Eshed
3   Department of Diagnostic Imaging, Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Iwona Sudoł-Szopińska
4   Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland and Imaging Diagnostic Department, Warsaw Medial University, Warsaw, Poland
,
Anne Grethe Jurik
2   Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
› Author Affiliations
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Publication History

Publication Date:
19 April 2018 (online)

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Abstract

Objective To review the strengths, limitations, and new insights in the anatomy and magnetic resonance imaging (MRI) features of active and structural lesions of sacroiliitis in spondyloarthritis.

Discussion MRI plays a key role in the diagnosis and follow-up of sacroiliitis in spondyloarthritis. MRI of the sacroiliac joints in affected patients may show active lesions such as bone marrow edema, capsulitis, enthesitis, or synovitis as well as structural changes such as erosion, fat infiltration, sclerosis, backfill, and ankylosis. Active lesions of sacroiliitis on MRI are particularly important for the diagnosis and assessment of ongoing active inflammation. Structural lesions increasingly gain importance for diagnosis and follow-up.

Conclusion Active lesions remain the hallmark for assessment of inflammation in sacroiliitis. Structural lesions increasingly play a role in the diagnosis of spondyloarthritis.

Keywords

magnetic resonance imaging - sacroiliitis - spondyloarthritis - active lesion - structural lesion
 

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