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Related Experiment Videos

Imaging in ankylosing spondylitis.

Walter P Maksymowych1, Robert Landewé

  • 1Department of Medicine, University of Alberta, 562 Heritage Medical Research Building, Edmonton, Alta., Canada T6G 2S2. walter.maksymowych@ualberta.ca

Best Practice & Research. Clinical Rheumatology
|June 17, 2006
PubMed
Summary

New imaging techniques, particularly MRI, show promise for detecting early inflammation in ankylosing spondylitis (AS). While X-rays are less sensitive, MRI offers a more detailed view of bone marrow changes in AS patients.

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Area of Science:

  • Rheumatology
  • Radiology
  • Inflammatory Diseases

Background:

  • Ankylosing spondylitis (AS) management is evolving with new therapies targeting tumor necrosis factor alpha.
  • Evaluating the structure-modifying potential of these therapies requires sensitive imaging techniques.
  • Current plain radiographic scoring methods for AS have limitations in responsiveness and detection of early changes.

Purpose of the Study:

  • To review the utility of various imaging modalities for assessing structural changes in ankylosing spondylitis.
  • To highlight the advancements in magnetic resonance imaging (MRI) for detecting early inflammatory processes in AS.
  • To discuss the responsiveness and limitations of current imaging scoring systems.

Main Methods:

  • Review of existing literature on imaging techniques for ankylosing spondylitis.

Related Experiment Videos

  • Comparison of plain radiography (modified Stoke AS Spinal Score) with MRI.
  • Evaluation of scoring systems for spinal and sacroiliac joint inflammation on MRI.

    • Main Results:

    • The modified Stoke AS Spinal Score is the most responsive radiographic method but requires long-term follow-up.
    • MRI, especially with fat-suppression, is highly sensitive for detecting bone marrow inflammation in sacroiliac joints, an early AS sign.
    • Spinal inflammation can be reliably scored using MRI, with systems evaluating the entire spine or selected segments showing excellent responsiveness.

    Conclusions:

    • MRI represents a significant advancement in the diagnostic evaluation of ankylosing spondylitis.
    • Fat-suppression MRI effectively detects early bone marrow inflammation in AS.
    • Further research is needed to clarify the prognostic significance of acute MRI findings and develop methods for evaluating chronic changes.