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Seronegative spondyloarthropathies: what radiologists should know

  • Musculoskeletal Radiology
  • Published:
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Abstract

Inflammatory involvement of the spine and sacroiliac joints is the most peculiar feature of seronegative spondyloarthropathies (SpA), which include ankylosing spondylitis, psoriatic arthritis, reactive arthritis (Reiter’s syndrome), enteropathic spondylitis (related to inflammatory bowel diseases) and undifferentiated spondyloarthropathies. SAPHO syndrome may also be considered a SpA, but there is no clear agreement in this respect. Imaging, along with clinical and laboratory evaluation, is an important tool to reach a correct diagnosis and to provide a precise grading of disease progression, influencing both clinical management and therapy. Conventional radiography, which is often the first-step imaging modality in SpA, does not allow an early diagnosis. Computed tomography (CT) demonstrates with a very high spatial resolution the tiny structural alterations of cortical and spongy bone before they become evident on plain film radiographs. Magnetic resonance imaging (MRI) is the only modality that provides demonstration of bone marrow oedema, which reflects vasodilatation and inflammatory hyperaemia. The primary aim of this review article was to examine the involvement of the spine and sacroiliac joints in SpA using a multimodal radiological approach (radiography, CT, MRI), providing a practical guide for the differential diagnosis of these conditions.

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Conflict of interest

Francesco Paparo, Matteo Revelli, Alessia Semprini, Dario Camellino, Alessandro Garlaschi, Marco Amedeo Cimmino, Gian Andrea Rollandi, Antonio Leone declare no conflict of interest.

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Authors and Affiliations

  1. S.C. di Radiodiagnostica, E.O. Ospedali Galliera, Mura delle Cappuccine 14, 16128, Genoa, Italy

    Francesco Paparo & Gian Andrea Rollandi

  2. Servizio di Radiodiagnostica, Dipartimento di Medicina Interna, Università degli Studi di Genova, Viale Benedetto XV 6, 16132, Genoa, Italy

    Matteo Revelli & Alessandro Garlaschi

  3. Dipartimento di Bioimmagini e Scienze Radiologiche, Università Cattolica, Largo A. Gemelli 1, Rome, Italy

    Alessia Semprini & Antonio Leone

  4. Dipartimento di Medicina Interna, Clinica Reumatologica, Università degli Studi di Genova, Viale Benedetto XV 6, 16132, Genoa, Italy

    Dario Camellino & Marco Amedeo Cimmino

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  1. Francesco Paparo
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  2. Matteo Revelli
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Correspondence to Francesco Paparo.

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Paparo, F., Revelli, M., Semprini, A. et al. Seronegative spondyloarthropathies: what radiologists should know. Radiol med 119, 156–163 (2014). https://doi.org/10.1007/s11547-013-0316-5

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  • DOI: https://doi.org/10.1007/s11547-013-0316-5

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