Imaging in spondylitis.

PURPOSE OF REVIEW: The purpose of this review is to describe and evaluate recent findings with respect to imaging in ankylosing spondylitis. The review includes articles from the literature that were published in 2004.

RECENT FINDINGS: Three types of articles are described: methodological studies aimed at validating scoring methods for detecting inflammation and structural damage by plain radiography and magnetic resonance imaging, descriptive reviews on imaging in ankylosing spondylitis and two studies evaluating miscellaneous aspects of imaging. Methodological studies showed promising psychometric properties of scoring methods for assessing structural damage of the spine by plain radiography, and for assessing inflammation of the spine by magnetic resonance imaging. Based on methodological qualifications, a method of preference (the modified Stoke ankylosing spondylitis spine score) could be identified for assessing 2-year change in structural damage. A number of reviews outlined the particular potential of magnetic resonance imaging in evaluating characteristics of inflammation and structural changes in ankylosing spondylitis. Two unrelated studies showed the potential yields of multidetector computed tomography in detecting spinal fractures in ankylosing spondylitis, and of magnetic resonance imaging in detecting shoulder problems in ankylosing spondylitis.

SUMMARY: MRI inflammation may become an important outcome measure in clinical trials in ankylosing spondylitis patients, and plain radiography may be used to assess 2-year progression of structural damage of the spine in ankylosing spondylitis. The descriptive reviews may serve as an introduction in the field of imaging in ankylosing spondylitis, and the studies on multidetector computed tomography and magnetic resonance imaging in shoulder problems may have direct impact for the treatment of patients with ankylosing spondylitis in the clinical context.