Imaging in the Diagnosis and Monitoring of Axial Spondyloarthritis

According to a study published in the rheumatology journal RöFo, imaging plays a pivotal role in diagnosing and monitoring axial spondyloarthritis (axSpA), especially in detecting new bone formation.

This review examines the role of imaging in diagnosing and monitoring axSpA, emphasizing the importance of detecting new bone formation. It provides an overview of characteristic imaging findings across different modalities, including X-ray, magnetic resonance imaging  (MRI), and computed tomography (CT).

Each imaging modality has distinct diagnostic accuracies for detecting structural lesions and new bone formation. X-rays are useful for identifying syndesmophytes and ankylosis but have limitations in early detection, the authors noted. MRI is sensitive for early inflammatory changes and structural lesions, while CT offers detailed visualization of bone structures, making it useful for detecting subtle bone changes and confirming findings seen on X-rays or MRI.

Different imaging techniques provide valuable insights into disease progression and treatment response. Recognizing the significance of new bone formation and its differentiation from conditions such as diffuse idiopathic skeletal hyperostosis and osteophytes is essential for accurate diagnosis and effective management of axSpA.

Understanding the specific strengths and weaknesses of each imaging modality is critical for the accurate diagnosis and monitoring of axSpA, the researchers concluded. This knowledge aids in the effective management and treatment of patients, helping to track disease progression and response to therapy.

Reference
Ulas ST, Deppe D, Ziegeler K, Diekhoff T. New bone formation in axial spondyloarthritis: a review. Knochenneubildung bei axialer Spondyloarthritis: eine Übersichtsarbeit. Rofo. 2024;196(6):550-559. doi:10.1055/a-2193-1970