Novel imaging modalities in spondyloarthritis

Area of Science:

• Rheumatology and Musculoskeletal Imaging
• Diagnostic Imaging in Inflammatory Diseases

Background:

• Spondyloarthritis (SpA) diagnosis and monitoring benefit from advanced imaging techniques.
• Magnetic resonance imaging (MRI) and ultrasound (US) are key modalities for evaluating axial and peripheral SpA.
• Evolving definitions of imaging findings necessitate updated guidance for clinicians.

Purpose of the Study:

• To review the role, sensitivity, and specificity of MRI and ultrasound in diagnosing and monitoring SpA.
• To discuss the evolving definition of a 'positive MRI' for sacroiliac joints and spine.
• To provide guidance on the practical application and interpretation of these imaging modalities in daily practice.

Main Methods:

• Review of current literature on MRI and ultrasound in spondyloarthritis.
• Discussion of diagnostic criteria and interpretation of imaging findings.
• Analysis of the utility of imaging as a clinical and outcome measure.

Main Results:

• MRI and ultrasound demonstrate significant roles in detecting and monitoring inflammatory changes in SpA.
• The interpretation of 'positive MRI' findings, particularly in the sacroiliac joints and spine, is dynamic.
• Ultrasound is valuable for assessing peripheral manifestations including enthesitis and synovitis.

Conclusions:

• MRI and ultrasound are crucial tools for the comprehensive assessment of spondyloarthritis.
• Understanding evolving imaging definitions and differential diagnoses is essential for accurate interpretation.
• This review offers practical guidance for integrating advanced imaging into routine SpA management.