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Computed tomography in axial spondyloarthritis
1Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Current Opinion in Rheumatology
|March 15, 2018
Summary
Computed tomography (CT) offers new insights for diagnosing ankylosing spondylitis (AS). Low-dose CT effectively images the spine and sacroiliac joints, aiding in the evaluation of syndesmophytes and sacroiliitis.
Area of Science:
- Radiology
- Rheumatology
- Medical Imaging
Background:
- Computed tomography (CT) is increasingly utilized for imaging the spine and sacroiliac joint (SIJ) in ankylosing spondylitis (AS).
- Understanding the diagnostic and evaluative capabilities of CT in AS is crucial for patient management.
Purpose of the Study:
- To review new insights into the diagnosis and evaluation of ankylosing spondylitis (AS) through the application of computed tomography (CT).
Main Methods:
- Review of studies utilizing low-dose CT for syndesmophyte detection in the entire spine.
- Analysis of semiquantitative scoring reliability and validity in CT scans.
- Examination of sacroiliac joint (SIJ) changes on abdominal CT scans.
Main Results:
- Low-dose CT can image the entire spine for syndesmophytes, but human scoring reduces reliability.
- The thoracic spine is frequently involved with syndesmophytes, showing non-random distribution patterns.
- Abdominal CT scans reveal sacroiliitis in up to 35% of inflammatory bowel disease patients; urate crystal significance in axial spondyloarthritis is unclear.
Conclusions:
- Low-dose CT is a promising tool for ankylosing spondylitis (AS) evaluation.
- Future studies on syndesmophyte progression should consider the thoracic spine.
- Abdominal CT is valuable for detecting sacroiliitis-related changes.
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