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Imaging in Axial Spondyloarthritis: Evaluation of Inflammatory and Structural Changes

Walter P Maksymowych1

  • 1Department of Medicine, University of Alberta, 562 Heritage Medical Research Building, Edmonton, Alberta T6G 2S2, Canada.

Rheumatic Diseases Clinics of North America
|October 16, 2016
PubMed

Insights

Pelvic radiography is a common tool for sacroiliac joint evaluation, but magnetic resonance imaging (MRI) offers superior assessment of inflammation and structural changes in spondyloarthritis. Fat metaplasia on MRI indicates a key stage in disease progression.

Area of Science:

  • Radiology
  • Rheumatology
  • Medical Imaging

Background:

  • Pelvic radiography is the primary imaging modality for sacroiliac joint disease.
  • Radiography's limitations include unreliability and inability to directly assess inflammation.
  • Magnetic resonance imaging (MRI) is increasingly used for its direct assessment of inflammatory and structural changes.

Purpose of the Study:

  • To highlight the evolving role of imaging in spondyloarthritis classification.
  • To emphasize the diagnostic value of MRI over radiography for sacroiliac joint inflammation.
  • To discuss the significance of fat metaplasia in disease progression.

Main Methods:

  • Review of current imaging practices in sacroiliac joint evaluation.
  • Comparison of diagnostic capabilities of radiography and MRI.
  • Analysis of the role of imaging in new spondyloarthritis classification criteria.

Main Results:

  • MRI directly assesses inflammatory and structural changes in the sacroiliac joints.
  • Fat metaplasia on T1-weighted MRI is an important indicator of disease progression.
  • Both radiography and MRI are integrated into new classification criteria for spondyloarthritis.

Conclusions:

  • MRI is a crucial tool for evaluating sacroiliac joint inflammation and structural changes in spondyloarthritis.
  • Fat metaplasia on MRI signifies an intermediate stage towards ankylosis.
  • Combined imaging modalities improve the classification of early and established spondyloarthritis.
Keywords:
AnkylosisBone edemaErosionFat metaplasiaMRIRadiography

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