Bildgebung bei axialer Spondyloarthritis – Herausforderungen und Limitationen

Kiefer, David; Baraliakos, Xenofon

doi:10.1055/a-0994-9814

Cited by 2 publications

(2 citation statements)

References 83 publications

(89 reference statements)

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“…Both conditions can lead to reduced spinal mobility, affecting the range of motion of the neck, back, and hips, resulting in impaired physical function [11,[28][29][30]. Chest expansion, typically reduced in advanced stages if axSpA, may also be reduced in up to 50% of patients with DISH [3] mainly due to the characteristic involvement of consecutive vertebral segments [31]. Peripheral manifestations like arthritis, dactylitis, and enthesitis are more common in SpA than in DISH.…”

Section: Similarities and Differences In Clinical Featuresmentioning

confidence: 99%

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Diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis—similarities and differences

Kiefer,

Khan,

Baraliakos

2023

Explor Musculoskeletal Dis

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Diffuse idiopathic skeletal hyperostosis (DISH) and axial spondyloarthritis (axSpA) are diseases with inflammatory involvement of the axial skeleton that can result in new bone formation that may lead to total ankylosis of the spine and functional impairment of different extent in individual patients. In these diseases, the new bone formation may lead to total ankylosis of the spine and impaired mobility with functional impairment. This review will highlight the similarities and differences of these two conditions. In axSpA, the genetic background with the association with human leukocyte antigen-B27 (HLA-B27) is known for 50 years, while in DISH, a genetic contribution is not yet proven. The phenotype of new bone formation and its anatomic features are different between these diseases. In axSpA symmetric, thin and marginal syndesmophytes representing an ossification of enthesitic inflammation at the area of the attachment of the annulus fibrosus that may extend to the adjacent deeper layers anterior longitudinal ligament and are typical, while in DISH the so-called “chunky bridging osteophytes” grow as an additional layer on the anterior longitudinal ligament. Besides distinct anamnestic and clinical features, magnetic resonance imaging is helpful differentiating the two diseases since inflammatory changes with the typical pattern of axSpA are reliably visualized. Similar in both diseases is the high prevalence of vertebral fractures, which are mainly caused by the local osteoporosis and decreased flexibility of the affected bones, and therefore may occur even after minor traumata. The presence of extraarticular manifestations like uveitis, inflammatory bowel disease or psoriasis are only linked to axSpA. In contrast, DISH is associated with obesity, diabetes mellitus, and other metabolic diseases. Although DISH and axSpA are distinct conditions, the cooccurrence of these two diseases exists in some patients. Various therapeutic options are becoming available for axSpA, but no therapy has been approved for DISH yet.

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Section: Similarities and Differences In Clinical Featuresmentioning

confidence: 99%

“…It may also visualize hyperostosis at the sites of entheses, such as the iliac crest and ischial tuberosity [24]. For clear identification of DISH, CR of the thoracic spine is used for the classification in order to prove the occurrence of the Resnick criteria [31].…”

Section: Similarities and Differences In Imagingmentioning

confidence: 99%

Diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis—similarities and differences

Kiefer,

Khan,

Baraliakos

2023

Explor Musculoskeletal Dis

Self Cite

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Prevalence and location of inflammatory and structural lesions in patients with rheumatoid arthritis and radiographic axial spondyloarthritis with chronic neck pain evaluated by magnetic resonance imaging

Kiefer,

Soltani,

Damirchi

et al. 2024

Arthritis Res Ther

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Objective Define the prevalence and location of inflammatory and structural lesions on magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA) and radiographic axial spondyloarthritis (r-axSpA) with neck pain as leading clinical symptom. Methods Patients with diagnosis of RA and r-axSpA were consecutively included if they had chronic (> 3 months) neck pain. Clinical assessment, neck pain questionnaires and MRIs of the cervical spine (CS) were performed. Results 107 patients (59 RA and 48 r-axSpA) were included. While there was no difference in the Northwick-Park-Neck-Pain-questionnaire, patients with RA reported higher neck pain compared to r-axSpA on a numeric rating scale (5.0 ± 3.6 vs. 3.0 ± 3.1; p = 0.003). Inflammatory lesions occurred predominantly in the craniocervical area in RA and in the lower CS segments in r-axSpA. Bone marrow edema (BME) was more frequent in axSpA (BME-score axSpA/RA: 0.35vs0.17; p < 0.001) while synovitis was visible in both but was more prevalent in RA (synovitis-score axSpA/RA: 0.02vs0.1; p < 0.001). BME was found in 8 (13.6%) vertebral corner vs. 9 (18.8%), in 2 (3.4%) facet joints vs. 7 (14.6%) and in 1 (1.7%) spinous processes vs. 9 (18.8%) in patients with RA/r-axSpA. In contrast, more patients with RA (30.5% vs6.3%) showed erosive osteochondrosis with endplate BME (p = 0.002). Conclusion While involvement of upper cervical inflammation was typically present in RA, r-axSpA patients showed more BME in lower CS segments, vertebral corners, facet joints and spinous processes. Neck pain is linked to upper and lower inflammatory and structural lesions of the CS in both diseases.

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Bildgebung bei axialer Spondyloarthritis – Herausforderungen und Limitationen

Cited by 2 publications

References 83 publications

Diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis—similarities and differences

Diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis—similarities and differences

Prevalence and location of inflammatory and structural lesions in patients with rheumatoid arthritis and radiographic axial spondyloarthritis with chronic neck pain evaluated by magnetic resonance imaging

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