![]() They are useful in diagnosing patients earlier in the disease process, particularly those without spondyloarthritis on imaging. read more, 3 Diagnosis references Ankylosing spondylitis is the prototypical spondyloarthropathy and a systemic disorder characterized by inflammation of the axial skeleton, large peripheral joints, and digits nocturnal back. read more, 2 Diagnosis references Ankylosing spondylitis is the prototypical spondyloarthropathy and a systemic disorder characterized by inflammation of the axial skeleton, large peripheral joints, and digits nocturnal back. AJNR Am J Neuroradiol.1991 Nov-Dic 12(6):1113-14.Although there are several existing diagnostic criteria for patients with suspected ankylosing spondylitis, the Assessment of SpondyloArthritis international Society (ASAS) criteria ( 1 Diagnosis references Ankylosing spondylitis is the prototypical spondyloarthropathy and a systemic disorder characterized by inflammation of the axial skeleton, large peripheral joints, and digits nocturnal back. Pseudoarthrosis in ankylosing spondylitis mimicking infectious diskitis: MR appearance. Eschelman DJ, Beers GJ, Naimark A and Yablon I. Spinal fractures and pseudoarthrosis complicating ankylosing spondylitis: MRI manifestation and clinical significance. Ankylosing spondylitis complicated by trauma: MR findings correlated with plain radiographs and CT. Goldberg AL, Keaton NL, Rothfus WE and Daffner RH. Cervical spondylodiscitis in a patient with ankylosing spondylitis. Lim KL, Chaudhuri K, Johnston RA and Sturrock RD. Discovertebral destruction in ankylosing spondylitis: the role of computed tomography and magnetic resonance imaging. Inflammatory changes takes place at the discovertebral junction, and it has been shown that, in the early inflammatory stage of the disease, the areas of increased T2 signal and “target”Įnhancement with gadolinium may be observed in the disc. However, in PA before fibrous tissue replacement of the disc material is achieved, a spectrum of On the other hand, infective spondylitis typically shows an increased signal intensity in T2WI. The intervertebral disc showed, in most cases of longstanding PA, low signal intensity in T1 and T2WI, consistent with fibrous tissue replacement of theĭisc. Early MR imaging studies suggested that the pattern of T1WI and T2WI signal intensity changes could readilyĭistinguish PA from infectious spondylitis. It is important to point out that fracture of the posterior elements and disruption of the ALL contributeīoth to differentiate PA from infectious spondylitis and to state spinal instability. Inflammatory changes of the epidural soft tissue or at the facet joints are also included. Among these possible abnormalities the disruption of the anterior longitudinal ligament (ALL), the dural adhesions and, the spinal stenosis secondary to Of the soft tissues, ligaments and the dura. MRI has been advocated as the study of choice for spinal PA in patients with AS as it allows not only to demonstrate the posterior elements fracture but also to identify the associated abnormalities Usually CT with multiplanar reconstruction (MPR) and Magnetic Resonance (MR) imaging is needed to evaluate the extent of the disease and to allow the differentiation from infectious spondylodiscitis. Radiographic abnormalities may be sufficient to suggest the diagnosis but On X-ray examinations, PA typically presents as an extensive destructive lesion of theĭiscovertebral junction, with disc space narrowing, bone destruction, a surrounding zone of sclerosis and local kyphosis. The fracture into the posterior elements and the clinical context help to establish the appropriated diagnosis. A paraspinal soft tissue swelling may also be present and the lesion can radiographically simulate an infective process. Although PA has been attributed to inflammatory process, nowadays it is believed to indicate, in most cases, an occult or stress fracture, especially when itĪlso affects the posterior elements of the vertebra. Cervical spine PA associated to AS occurs extremely rarely and very few cases have been reported, all of them affecting the lowĬervical spine (C5-C6 and C6-C7 levels). This lesion tends to affect the thoracolumbar spine. Pseudoarthrosis (PA) of the spine, also called Andersson lesion or spondylodiscitis, is believed to be a very unusual although serious complication in patients with longstanding ankylosing
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