Peripheral Seronegative Spondyloarthritis – Updates on Critical Criteria

Abstract

In the past decade, new clinical and imaging criteria have vastly improved the diagnosis and outcome of patients with seronegative spondyloarthritis (SpA). It is estimated that up to 30% of patients with SpA may exhibit predominant (or only) peripheral manifestations of SpA. Lack of awareness can lead to a diagnostic delay of up to 8–9 years which can lead to significant patient morbidity. It is, therefore, essential to diagnose and treat SpA as early as possible. The aim of this pictorial review is to emphasize the important aspects of current peripheral SpA classification system and demonstrates the imaging findings related to peripheral SpA. Patients referred for imaging of peripheral joints can be from a wide referral source. Recognizing and reporting imaging features suggestive of peripheral SpA will allow appropriate and timely specialist referral with the aim of avoiding treatment delay.

Ocular Manifestations of Spondyloarthritis

“…They have an estimated global incidence of 1%. 1 Non-radiographic axial SpA is also common; a cross-sectional survey conducted in Asian patients with inflammatory back pain found that 36.46% of them met its classification criteria. 2 The exact aetiopathogenesis of this condition is not yet fully understood; however, involvement of immune mediators on the background of several genetic, familial and environmental predispositions are considered important.…”

Ankle and Foot: Focus on Inflammatory Disease

“…MRI protocols should take into consideration technical challenges including off-isocenter imaging to ensure detection of altered marrow signal intensity. 13 Dixon algorithm-based sequences may be a solution to produce uniform fat suppression. 13…”

“…MRI protocols should take into consideration technical challenges including offisocenter imaging to ensure detection of altered marrow signal intensity. 13 Dixon algorithm-based sequences may be a solution to produce uniform fat suppression. Tissue vascularization can be broadly assessed clinically with conventional Doppler US techniques, but these have limitations in detecting low-velocity blood flow.…”

Exames complementares das entesopatias. Parte 4 – Imagem: ressonância magnética

“…Os achados clássicos de entesite na RM são o aumento da espessura e alteração de sinal da inserção tendínea e, principalmente, o inequívoco edema perienteseal, envolvendo a medular óssea subcortical, a bainha tendínea ou paratendão, te-cido adiposo e bursas adjacentes 25 . As alterações inflamatórias tendíneas e peritendíneas devem ser evidentes e desproporcionais à degeneração do tendão, diferentemente do que ocorre na tendinopatia degenerativa, na qual a degeneração do tendão é o achado principal, podendo estar ou não associada ao edema na medular óssea subcortical, geralmente mais discreto 7 , embora, não raramente, esta diferenciação só possa ser feita com a evolução da doença.…”