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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
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Early axial spondyloarthritis.
1Pediatric Translational Research Branch, National Institute of Arthritis Musculoskeletal and Skin Diseases, Bethesda, Maryland, USA. colbertr@mail.nih.gov
Current Opinion in Rheumatology
|July 2, 2010
Summary
Recent advances in classifying preradiographic axial spondyloarthritis (SpA) focus on early inflammation detection. New criteria incorporating MRI and HLA-B27 testing aid in identifying patients for trials to prevent ankylosing spondylitis progression.
Area of Science:
- Rheumatology
- Immunology
- Radiology
Background:
- Sacroiliac joint inflammation precedes radiographic damage in ankylosing spondylitis (AS).
- Preradiographic axial spondyloarthritis (SpA) presents with axial symptoms but lacks AS diagnostic criteria.
- Clinical features of axial SpA often mimic early AS.
Purpose of the Study:
- To summarize recent advancements in the classification of preradiographic axial spondyloarthritis (SpA).
Main Methods:
- Magnetic resonance imaging (MRI) detects sacroiliac joint inflammation, predicting AS development.
- Whole-body MRI visualizes additional disease involvement, though its sensitivity compared to conventional MRI requires further assessment.
- Incorporation of MRI and HLA-B27 testing into classification criteria for preradiographic axial disease.
Main Results:
- MRI is crucial for identifying early sacroiliac joint inflammation in axial SpA.
- New classification criteria for axial SpA have been developed.
- These criteria aid in identifying patients for clinical trials.
Conclusions:
- Classification criteria for axial SpA facilitate patient identification for trials.
- Early intervention strategies can be tested to slow the progression to AS.
- This research aims to prevent structural damage leading to AS.
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