Advertisement

Rheumatology International

, Volume 32, Issue 1, pp 69–72 | Cite as

Evaluation of complex appearance in vascularity of sacroiliac joint in ankylosing spondylitis by color Doppler ultrasonography

  • Jiaan ZhuEmail author
  • Chunyan Xing
  • Yeqing Jiang
  • Yizhou Hu
  • Bing Hu
  • Niansong Wang
Original Article

Abstract

To investigate the complex appearance of vascularity of sacroiliac joint (SIJ) in ankylosing spondylitis. Sixty-eight patients and 35 controls were included in the study. Blood flow was examined at the SIJ by using color Doppler ultrasonography (CDUS). The location of color flow signs and flow pattern were observed. Arteries do not present reversed phase in diastolic phase on pulse Doppler sonography, and if they were found inside and around the SIJ, the resistive index (RI) was measured. In active AS patients, the region of SIJ presented increased vascularization greater than those in inactive AS (P = 0.001) and the controls (P = 0.001). There are three different spectral Doppler tracings: arterial flow (RI < 1), arterial flow representing reversed phase in diastolic phase on spectral Doppler sonography and venous flow. Besides arterial flow signs, most of color flow signs presented venous flow in active AS. Significant increases in a number of venous flow signs in active AS cases (P < 0.001) were observed. In most cases, two or more different flow patterns presented in a region very close to the location of SIJ. In addition, a different vascularization was observed. Abnormal vascularization at the sacroiliac joints can be detected by CDUS. The vascularization in SIJ presented complex appearance, which increases the difficulties of CDUS examination. Venous blood flow in the assessment of active AS merits further study.

Keywords

Ankylosing spondylitis Sacroiliac joint Sacroiliitis Color Doppler ultrasonography 

Notes

Acknowledgments

We thank Robert Yu (University of Texas M.D. Anderson Cancer Center, US) in reviewing and revising the English translation. We affirm that we have no financial interest (payment, stock holdings, consultantship, honoraria, or employment) or relationship in the past years with any commercial company with potential interest in the subject matter enclosed in this manuscript.

References

  1. 1.
    Creemers MC, Franssen MJ, van’t Hof MA et al (2005) Assessment of outcome in ankylosing spondylitis: an extended radiographic scoring system. Ann Rheum Dis 64(1):127–129PubMedCrossRefGoogle Scholar
  2. 2.
    van der Heijde D, Landewe R (2005) Imaging in spondylitis. Cur Opi Rheumatol 17(4):413–417CrossRefGoogle Scholar
  3. 3.
    Wendling D, Toussirot E, Streit G et al (2006) Imaging study scores for ankylosing spondylitis. Joint Bone Spine 73(6):655–660PubMedCrossRefGoogle Scholar
  4. 4.
    Levine DS, Forbat SM, Saifuddin A (2004) MRI of the axial skeletal manifestations of ankylosing spondylitis. Clin Radiol 5(5):400–413CrossRefGoogle Scholar
  5. 5.
    Arslan H, Sakarya M, Adak B et al (1999) Duplex and colour Doppler sonographic findings in active sacroiliitis. AJR Am J Roentgenol 173(3):677–680PubMedGoogle Scholar
  6. 6.
    Unlü E, Pamuk ON, Cakir N (2007) Color and duplex Doppler sonography to detect sacroiliitis and spinal inflammation in ankylosing spondylitis. Can this method reveal response to anti-tumor necrosis factor therapy? J Rheumatol 34(1):110–116PubMedGoogle Scholar
  7. 7.
    Van der Linden S, Valkenburg HA et al (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 27(4):361–368PubMedCrossRefGoogle Scholar
  8. 8.
    Drouart M, Saas P, Billot M et al (2003) High serum vascular endothelial growth factor correlates with disease activity of spondylarthropathies. Clin Exp Immunol 132(1):158–162PubMedCrossRefGoogle Scholar
  9. 9.
    Mease PJ (2008) Spondyloarthritis update: new insights regarding classification, pathophysiology, and management. Bull NYU Hosp Jt Dis 66(3):203–209PubMedGoogle Scholar
  10. 10.
    Klauser A, Halpern EJ, Frauscher F et al (2005) Inflammatory low back pain: high negative predictive value of contrast-enhanced color Doppler ultrasound in the detection of inflamed sacroiliac joints. Arthritis Care Res 53:440–444CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Jiaan Zhu
    • 1
    Email author
  • Chunyan Xing
    • 1
  • Yeqing Jiang
    • 1
  • Yizhou Hu
    • 1
  • Bing Hu
    • 1
  • Niansong Wang
    • 2
  1. 1.Department of Ultrasound in MedicineShanghai Jiaotong University Affiliated Sixth People’s HospitalShanghaiChina
  2. 2.Department of RheumatologyShanghai Jiaotong University Affiliated Sixth People’s HospitalShanghaiChina

Personalised recommendations