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Skeletal Radiology

, Volume 29, Issue 1, pp 27–33 | Cite as

Marginal erosive discovertebral ”Romanus” lesions in ankylosing spondylitis demonstrated by contrast enhanced Gd-DTPA magnetic resonance imaging

  • V. Jevtic
  • M. Kos-Golja
  • B. Rozman
  • I. McCall
Article

Abstract 

Objective. To assess the value of Gd-DTPA magnetic resonance (MR) imaging in the demonstration of marginal destructive discovertebral Romanus lesions in ankylosing spondylitis.

Design and patients. A prospective study of Gd-DTPA MR imaging was performed in 39 patients with a clinical diagnosis of ankylosing spondylitis and typical Romanus lesions seen on radiographs of the thoracolumbar spine. MR morphological appearances and signal intensity changes at the discovertebral junctions were analysed and compared with the radiographic findings.

Results. Ninety-nine discovertebral junctions with Romanus lesions showed low signal intensity on T1-weighted and high signal on T2-weighted and T1-weighted postcontrast images at the vertebral corners consistent with oedematous hyperaemic inflammatory tissue. There were nine discovertebral junctions with similar MR findings but normal radiographs. Fifty-three discovertebral junctions showed syndesmophyte formation with increased signal intensity on both T1- and T2-weighted images with no contrast enhancement. Sixty-five discovertebral junctions showed a mixture of radiographic features and varied high and low signal changes at the vertebral rim on MR imaging with rims of enhancement in the vertebral body following contrast administration.

Conclusion. Gd-DTPA MR imaging demonstrates a variable signal pattern and degree of contrast enhancement which may reflect the evolutionary stages of discovertebral enthesitis in ankylosing spondylitis. MR imaging may identify early erosive changes in radiographically normal vertebra. The role of MR imaging needs further investigation.

Key words Ankylosing spondylitis Thoracolumbar spine MR imaging Contrast enhancement 

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Copyright information

© International Skeletal Society 2000

Authors and Affiliations

  • V. Jevtic
    • 1
  • M. Kos-Golja
    • 2
  • B. Rozman
    • 2
  • I. McCall
    • 3
  1. 1.Clinical Radiology Institute, University Clinical Centre, Zaloska 7, 1525 Ljubljana, SloveniaSI
  2. 2.Department of Rheumatology, University Clinical Centre, 1525 Ljubljana, SloveniaSI
  3. 3.The Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire SY10 7AG, UKGB

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