Rheumatology Medical News about spondyloarthritis;imaging

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Progress in spondylarthritis. Spondyloarthritis: Lessons from imaging
Arthritis Research & Therapy, 05/20/09

Maksymowych WP – Recent advances in imaging like plain radiography, computed tomography (CT), scintigraphy, ultrasound, and MRI now permit the object evaluation of inflammation and its sequelae in both the axial and peripheral skeleton in pts with spondyloarthritis (SpA). The present review addresses the key lessons learnt from studies evaluating each of these imaging modalities according to the following questions:

What pathological feature is best shown by each method?
What does each method tell us about the pathophysiology of disease?
How does each method facilitate evaluation of patients presenting early in their disease course?
What are the advantages and limitations of outcome assessment tools developed for each method?

Conclusions drawn:

Plain radiography continues to be the primary approach for the evaluation of SpA in routine practice
MRI is now established as the most sensitive imaging modality for the assessment of active inflammation
Ultrasound appears to be particularly useful in the assessment of peripheral enthesitis
There is increasing evidence that acute lesions on MRI also have predictive validity for radiographic abnormalities in both the SIJs and the spine
Further work is required to clarify the sensitivity and specificity of MRI lesions

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