Abstract
MRI represents a fundamental technique in the diagnosis of spondyloarthritis and the gold standard technique to detect early changes of the disease.
MR findings of spondyloarthritis are typical but not specific. It is mandatory that an efficient imaging protocol is needed.
Typical lesions in spondyloarthritis comprise: spondylitis, discitis, spondylodiscitis, sacroiliitis, osteoarthritis (of the facet joints, costovertebral, and costotrasverse joints), and enthesitis.
Lesions may be acute (i.e., bone marrow edema—osteitis, synovitis, capsulitis, enthesitis) or chronic (i.e., osteosclerosis, bone erosions, fat deposition, bony bridges/ankylosis).
MRI clearly detects all the above mentioned changes. In particular, bone marrow edema appears as hyperintense on T2-weighted images with Fat Saturation and STIR images. Contrast enhancement of the cancellous bone indicates osteitis. Contrast enhancement of synovia, joint capsule, and ligaments indicates, respectively, synovitis, capsulitis, and enthesitis.
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D’Aprile, P., Tarantino, A. (2020). MRI in Spondyloarthritis. In: MRI of the Rheumatic Spine. Springer, Cham. https://doi.org/10.1007/978-3-030-32996-9_2
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