Axial Spondyloarthritis: Mimics and Pitfalls of Imaging Assessment

Frontiers in Medicine

article

António Proença Caetano¹  Vasco V. Mascarenhas²  Pedro M. Machado⁴ 

[1] Radiology Department, Hospital de Curry Cabral, Centro Hospitalar Universitário Lisboa Central;Musculoskeletal Imaging Unit, Radiology Department, Imaging Center, Hospital da Luz;EpiDoC Unit, Chronic Diseases Research Centre, NOVA Medical School;Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, United Kingdom;National Institute for Health Research (NIHR) Biomedical Research Centre, University College London Hospitals National Health Service Foundation Trust, United Kingdom;Department of Rheumatology, London North West University Healthcare National Health Service Trust, United Kingdom

关键词: axial spondyloarthritis;    magnetic resonance imaging;    radiography;    computed tomography;    differential diagnosis;    pitfall;    normal variant;    mimic;   

DOI  :  10.3389/fmed.2021.658538

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Axial spondyloarthritis (axSpA) is a chronic inflammatory disorder that predominantly involves the axial skeleton. Imaging findings of axSpA can be divided into active changes, which include bone marrow edema, synovitis, enthesitis, capsulitis, and intra-articular effusion, and structural changes, which include erosions, sclerosis, bone fatty infiltration, fat deposition in an erosion cavity, and bone bridging or ankylosis. The ability to distinguish between imaging lesions suggestive of axSpA and artifacts or lesions suggestive of other disorders is critical for the accurate diagnosis of axSpA. Diagnosis may be challenging, particularly in early-stage disease and magnetic resonance imaging (MRI) plays a key role in the detection of subtle or inflammatory changes. MRI also allows the detection of structural changes in the subchondral bone marrow that are not visible on conventional radiography and is of prognostic and monitoring value. However, bone structural changes are more accurately depicted using computed tomography. Conventional radiography, on the other hand, has limitations, but it is easily accessible and may provide insight on gross changes as well as rule out other pathological features of the axial skeleton. This review outlines the imaging evaluation of axSpA with a focus on imaging mimics and potential pitfalls when assessing the axial skeleton.

【 授权许可】

CC BY