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Imaging in spondylitis.

Désirée van der Heijde1, Robert Landewé

  • 1University Hospital Maastricht & CAPHRI Research Institute, Maastricht, The Netherlands. dhe@sint.azm.nl

Current Opinion in Rheumatology
|June 16, 2005
PubMed
Summary

Recent imaging studies show magnetic resonance imaging (MRI) can detect inflammation in ankylosing spondylitis (AS) for clinical trials. Plain radiography is useful for tracking spinal structural damage progression over two years in AS patients.

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Area of Science:

  • Radiology
  • Rheumatology
  • Medical Imaging

Background:

  • Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine.
  • Accurate imaging is crucial for diagnosis, monitoring disease activity, and assessing structural damage.
  • Recent advancements in imaging techniques offer new possibilities for evaluating AS.

Purpose of the Study:

  • To review and evaluate recent findings (published in 2004) on imaging modalities in ankylosing spondylitis.
  • To assess the utility of various imaging techniques for detecting inflammation and structural damage in AS.
  • To identify preferred scoring methods for radiographic and MRI assessments in AS.

Main Methods:

  • Review of literature published in 2004 concerning imaging in ankylosing spondylitis.
  • Analysis of methodological studies validating scoring methods for plain radiography and MRI.
  • Evaluation of descriptive reviews and studies on multidetector computed tomography (MDCT) and MRI for specific AS manifestations.

Main Results:

  • Methodological studies demonstrated promising psychometric properties for scoring methods in assessing spinal inflammation (MRI) and structural damage (plain radiography).
  • The modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) was identified as a preferred method for assessing 2-year structural damage progression.
  • MRI shows significant potential for evaluating inflammatory characteristics and structural changes in AS; MDCT and MRI also showed utility in detecting spinal fractures and shoulder problems, respectively.

Conclusions:

  • Magnetic resonance imaging (MRI) may become a key outcome measure for assessing inflammation in clinical trials for ankylosing spondylitis.
  • Plain radiography is suitable for monitoring the 2-year progression of spinal structural damage in AS patients.
  • Findings on MDCT and MRI for specific issues like fractures and shoulder problems may directly influence clinical management of AS.

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