Abstract
Spondyloarthritis (SpA) is a group of chronic inflammatory conditions which severely impact quality of life. Several criteria have been developed in the past to aid the diagnosis of SpA based on symptoms and radiographic changes during the course of the disease. However, it takes several years before structural changes manifest on conventional radiographs, leading to a diagnostic delay of 6 to 10 years. The use of MRI and its incorporation into the Assessment of Spondyloarthritis (ASAS) criteria, has radically changed the diagnosis of SpA in the last decade by allowing visualisation of both active and chronic inflammatory changes and enabling clinicians to recognise SpA during it’s early stage and initiate treatment. An understanding of the various terminology used in the divisions of disease presentations and their relevant imaging findings are key, along with the use of clear definitions of structural and inflammatory changes on MRI, in ensuring accurate diagnosis and classification of SpA.
Highlights
Spondyloarthritis (SpA) is a spectrum of immune-mediated chronic inflammatory changes and encompasses a variety of rheumatic diseases such as ankylosing spondylitis, psoriatic arthritis, reactive arthritis and entheropatic arthritis
SpA can broadly be divided into axial SpA and peripheral SpA depending on the involvement of the spine and axial skeleton
Presence of bone marrow oedema is essential for the diagnosis of active sacroilitis; the presence of other lesions such as synovitis, enthesis or capsulitis marrow oedema without the presence of BMO/ osteitis is debatable and cannot be classified as active inflammation
Summary
Classification Terminology and Definitions in Reporting of MRI in Axial Spondyloarthritis. Several criteria have been developed in the past to aid the diagnosis of SpA based on symptoms and radiographic changes during the course of the disease. It takes several years before structural changes manifest on conventional radiographs, leading to a diagnostic delay of 6 to 10 years. An understanding of the various terminology used in the divisions of disease presentations and their relevant imaging findings are key, along with the use of clear definitions of structural and inflammatory changes on MRI, in ensuring accurate diagnosis and classification of SpA
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