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Spondyloarthropathy
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Formerly called seronegative spondyloarthropathy, spondyloarthritis
              • Axial spondyloarthritis
            • Definitions

              • RF(-) inflammatory arthritis and enthesopathy affecting spine and sacroiliac joints (SIJs)
                • Archetype is ankylosing spondylitis (AS)
              • Enthesopathy: Inflammation at attachments of ligaments and tendons (entheses)
              • Syndesmophyte: Paraspinous ligamentous or disc ossification bridging 2 adjacent vertebral bodies

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Carvalho PD et al: How to investigate: early axial spondyloarthritis. Best Pract Res Clin Rheumatol. 33(4):101427, 2019
                                            2. Taurog JD et al: Ankylosing spondylitis and axial spondyloarthritis. N Engl J Med. 374(26):2563-74, 2016
                                            3. Navallas M et al: Sacroiliitis associated with axial spondyloarthropathy: new concepts and latest trends. Radiographics. 33(4):933-56, 2013
                                            4. El Zahlawy H et al: Cervical spine osteolysis in a case of undifferentiated spondyloarthropathy with features mimicking neoplasm or infection. Spine (Phila Pa 1976). 34(24):E901-5, 2009
                                            5. Guglielmi G et al: Imaging of the sacroiliac joint involvement in seronegative spondylarthropathies. Clin Rheumatol. 28(9):1007-19, 2009
                                            6. Landewé RB et al: Clinical assessment and outcome research in spondyloarthritis. Curr Rheumatol Rep. 11(5):334-9, 2009
                                            7. Rudwaleit M et al: The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part I): classification of paper patients by expert opinion including uncertainty appraisal. Ann Rheum Dis. 68(6):770-6, 2009
                                            8. Rudwaleit M et al: The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 68(6):777-83, 2009
                                            9. Vinson EN et al: MR imaging of ankylosing spondylitis. Semin Musculoskelet Radiol. 7(2):103-13, 2003
                                            10. Bollow M et al: Use of contrast enhanced magnetic resonance imaging to detect spinal inflammation in patients with spondyloarthritides. Clin Exp Rheumatol. 20(6 Suppl 28):S167-74, 2002
                                            11. Hitchon PW et al: Fractures of the thoracolumbar spine complicating ankylosing spondylitis. J Neurosurg. 97(2 Suppl):218-22, 2002
                                            12. Queiro R et al: Clinically asymptomatic axial disease in psoriatic spondyloarthropathy. A retrospective study. Clin Rheumatol. 21(1):10-3, 2002
                                            13. Cunnane G: Amyloid precursors and amyloidosis in inflammatory arthritis. Curr Opin Rheumatol. 13(1):67-73, 2001
                                            14. Sampaio-Barros PD et al: Undifferentiated spondyloarthropathies: a 2-year follow-up study. Clin Rheumatol. 20(3):201-6, 2001
                                            15. Shih TT et al: Spinal fractures and pseudoarthrosis complicating ankylosing spondylitis: MRI manifestation and clinical significance. J Comput Assist Tomogr. 25(2):164-70, 2001
                                            16. Janssen H et al: MR imaging of arthritides of the cervical spine. Magn Reson Imaging Clin N Am. 8(3):491-512, 2000
                                            17. Luong AA et al: Imaging of the seronegative spondyloarthropathies. Curr Rheumatol Rep. 2(4):288-96, 2000
                                            18. Mitra D et al: The prevalence of vertebral fractures in mild ankylosing spondylitis and their relationship to bone mineral density. Rheumatology (Oxford). 39(1):85-9, 2000
                                            19. Braun J et al: Radiologic diagnosis and pathology of the spondyloarthropathies. Rheum Dis Clin North Am. 24(4):697-735, 1998
                                            20. Deesomchok U et al: Clinical comparison of patients with ankylosing spondylitis, Reiter's syndrome and psoriatic arthritis. J Med Assoc Thai. 76(2):61-70, 1993
                                            21. Rosenkranz W: Ankylosing spondylitis: cauda equina syndrome with multiple spinal arachnoid cysts. Case report. J Neurosurg. 34(2 Pt 1):241-3, 1971
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Formerly called seronegative spondyloarthropathy, spondyloarthritis
                                                        • Axial spondyloarthritis
                                                      • Definitions

                                                        • RF(-) inflammatory arthritis and enthesopathy affecting spine and sacroiliac joints (SIJs)
                                                          • Archetype is ankylosing spondylitis (AS)
                                                        • Enthesopathy: Inflammation at attachments of ligaments and tendons (entheses)
                                                        • Syndesmophyte: Paraspinous ligamentous or disc ossification bridging 2 adjacent vertebral bodies

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Carvalho PD et al: How to investigate: early axial spondyloarthritis. Best Pract Res Clin Rheumatol. 33(4):101427, 2019
                                                                                      2. Taurog JD et al: Ankylosing spondylitis and axial spondyloarthritis. N Engl J Med. 374(26):2563-74, 2016
                                                                                      3. Navallas M et al: Sacroiliitis associated with axial spondyloarthropathy: new concepts and latest trends. Radiographics. 33(4):933-56, 2013
                                                                                      4. El Zahlawy H et al: Cervical spine osteolysis in a case of undifferentiated spondyloarthropathy with features mimicking neoplasm or infection. Spine (Phila Pa 1976). 34(24):E901-5, 2009
                                                                                      5. Guglielmi G et al: Imaging of the sacroiliac joint involvement in seronegative spondylarthropathies. Clin Rheumatol. 28(9):1007-19, 2009
                                                                                      6. Landewé RB et al: Clinical assessment and outcome research in spondyloarthritis. Curr Rheumatol Rep. 11(5):334-9, 2009
                                                                                      7. Rudwaleit M et al: The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part I): classification of paper patients by expert opinion including uncertainty appraisal. Ann Rheum Dis. 68(6):770-6, 2009
                                                                                      8. Rudwaleit M et al: The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 68(6):777-83, 2009
                                                                                      9. Vinson EN et al: MR imaging of ankylosing spondylitis. Semin Musculoskelet Radiol. 7(2):103-13, 2003
                                                                                      10. Bollow M et al: Use of contrast enhanced magnetic resonance imaging to detect spinal inflammation in patients with spondyloarthritides. Clin Exp Rheumatol. 20(6 Suppl 28):S167-74, 2002
                                                                                      11. Hitchon PW et al: Fractures of the thoracolumbar spine complicating ankylosing spondylitis. J Neurosurg. 97(2 Suppl):218-22, 2002
                                                                                      12. Queiro R et al: Clinically asymptomatic axial disease in psoriatic spondyloarthropathy. A retrospective study. Clin Rheumatol. 21(1):10-3, 2002
                                                                                      13. Cunnane G: Amyloid precursors and amyloidosis in inflammatory arthritis. Curr Opin Rheumatol. 13(1):67-73, 2001
                                                                                      14. Sampaio-Barros PD et al: Undifferentiated spondyloarthropathies: a 2-year follow-up study. Clin Rheumatol. 20(3):201-6, 2001
                                                                                      15. Shih TT et al: Spinal fractures and pseudoarthrosis complicating ankylosing spondylitis: MRI manifestation and clinical significance. J Comput Assist Tomogr. 25(2):164-70, 2001
                                                                                      16. Janssen H et al: MR imaging of arthritides of the cervical spine. Magn Reson Imaging Clin N Am. 8(3):491-512, 2000
                                                                                      17. Luong AA et al: Imaging of the seronegative spondyloarthropathies. Curr Rheumatol Rep. 2(4):288-96, 2000
                                                                                      18. Mitra D et al: The prevalence of vertebral fractures in mild ankylosing spondylitis and their relationship to bone mineral density. Rheumatology (Oxford). 39(1):85-9, 2000
                                                                                      19. Braun J et al: Radiologic diagnosis and pathology of the spondyloarthropathies. Rheum Dis Clin North Am. 24(4):697-735, 1998
                                                                                      20. Deesomchok U et al: Clinical comparison of patients with ankylosing spondylitis, Reiter's syndrome and psoriatic arthritis. J Med Assoc Thai. 76(2):61-70, 1993
                                                                                      21. Rosenkranz W: Ankylosing spondylitis: cauda equina syndrome with multiple spinal arachnoid cysts. Case report. J Neurosurg. 34(2 Pt 1):241-3, 1971