EditorialMRI in axial spondyloarthritis: From light to shadow?
Section snippets
MRI of the sacroiliac joint: the cornerstone of the imaging diagnosis – yet not without limitations
Inflammatory changes in the sacroiliac joints (indicating active sacroiliitis) are required to meet the MRI sacroiliitis criterion in classification criteria sets. The bone marrow edema (on STIR sequences) or osteitis (on postgadolinium T1 sequences) suggestive of spondyloarthritis must be marked and located at the typical anatomical sites. If there is a single inflammatory lesion, it must be visible on at least two contiguous sections, on either the iliac or the sacral side of the joint; in
Role for MRI of the spine
The ASAS consensus panel defined a positive MRI of the spine as the presence either of active inflammatory lesions defined as anterior/posterior spondylitis in at least three sites or of chronic damage defined as fat deposition at several vertebral corners [14]. Anterior/posterior spondylitis (also known as the MRI Romanus sign) generates a high-intensity signal on STIR images.
Other active lesions can be taken into account, such as non-infectious diskitis, costovertebral arthritis, facet joint
Prospects for the future
Although associations have been established between several types of MRI lesions and spondyloarthritis, MRI has a number of limitations, and the presence of MRI inflammation alone is not sufficient to diagnose spondyloarthritis [26]. The diagnostic performance of sacroiliac MRI can be improved by taking into account other types of lesions, most notably structural changes, present concomitantly with subchondral bone edema [27], [28]. The diagnostic contribution of spinal MRI compared to isolated
Disclosure of interest
The authors declare that they have no conflicts of interest concerning this article.
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