TY - JOUR T1 - Magnetic Resonance Imaging of Vertebral Erosion in Spondyloarthritis JF - The Journal of Rheumatology JO - J Rheumatol SP - 1791 LP - 1793 DO - 10.3899/jrheum.130972 VL - 40 IS - 11 AU - ROBERT G.W. LAMBERT Y1 - 2013/11/01 UR - http://www.jrheum.org/content/40/11/1791.abstract N2 - The association between ankylosing spondylitis (AS) and vertebral body erosion is long established. While originally thought of as a purely osteoproliferative condition leading to ankylosis, radiographic evidence of discovertebral destruction was first reported by Andersson1, and later the presence of erosion at the perimeter of the vertebral body was described by Romanus and Yden2. The stated intention of the latter publication was to “reexamine films taken at an earlier date, and previously interpreted as normal, so that we could study the very earliest stage of a syndesmophyte.” The authors then describe “very slight signs of a superficial destructive process on the vertebral bodies. This initial stage is followed by calcification, … and by ossification and structural alteration the typical syndesmophyte is formed.” Some interesting things are noteworthy from this early work: (1) Romanus and Yden were the first to describe the presence of erosion at the anterior corners of the vertebral body — a feature that is now widely known as the Romanus lesion on radiography in most radiology and rheumatology textbooks3,4. (2) They were also the first to describe the sclerotic reaction that causes the vertebra to “shine in the original x-ray film.” This feature has since been termed the “shiny corner” or “ivory corner”; although, somewhat confusingly, it is also but less often known as a “Romanus lesion.” (3) These authors were observing the sequence of radiographic events by which a syndesmophyte may be formed. They worked backwards, selecting a population of patients with syndesmophytosis, and were seeking to describe the diagnostic features of ankylosing spondylitis before the stage of calcification and ossification so as to enable earlier accurate diagnosis. So it has been clearly stated from the first publication that the presence of erosion at the corner of a … Address correspondence to Dr. Lambert; E-mail: rlambert{at}ualberta.ca ER -