The Role of Imaging in Diagnosing Axial Spondyloarthritis

Khmelinskii, Nikita; Regel, Andrea; Baraliakos, Xenofon

doi:10.3389/fmed.2018.00106

Cited by 37 publications

(33 citation statements)

References 115 publications

(144 reference statements)

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“…These changes, which are seen in more advanced disease, are not readily imaged using other techniques such as ultrasound, which cannot penetrate the bone surface [ 25 ]. However, plain radiography has limited utility in assessing the early soft-tissue changes seen in PsA [ 13 , 26 ], especially axial changes [ 27 ]. Radiographs taken during this stage of the disease can appear normal, resulting in a significant delay in diagnosis if other imaging modalities are not used.…”

Section: Introductionmentioning

confidence: 99%

Musculoskeletal Imaging for Dermatologists: Techniques in the Diagnosis and Management of Psoriatic Arthritis

Gottlieb

Bakewell

Merola

2021

Dermatol Ther (Heidelb)

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Psoriatic arthritis is an inflammatory condition affecting up to 30% of patients with psoriasis. Patients may experience irreversible joint damage if not treated early, and diagnostic delays of even 6 months are associated with radiographic progression and impaired function. Therefore, early detection and intervention are of critical importance in patients with psoriatic arthritis. Given that psoriasis often precedes symptoms of psoriatic arthritis, dermatologists are uniquely positioned to identify patients with psoriatic arthritis early in their disease course, before permanent damage has occurred. Several screening tools have been developed to help dermatologists identify patients who may have psoriatic arthritis, but these tools may not capture patients with subclinical disease or quantify the type and severity of the underlying tissue insult, which is often the presenting sign of psoriatic arthritis. In these cases, a combination of clinical assessment and musculoskeletal imaging (e.g., ultrasound) is required. This review summarizes three common musculoskeletal imaging techniques used in the diagnosis and management of patients with psoriatic arthritis: conventional radiography, ultrasound, and magnetic resonance imaging. Further understanding of musculoskeletal imaging will assist dermatologists in making treatment decisions and allow them to have a more active role in the detection of psoriatic arthritis.

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Section: Introductionmentioning

confidence: 99%

Musculoskeletal Imaging for Dermatologists: Techniques in the Diagnosis and Management of Psoriatic Arthritis

Gottlieb

Bakewell

Merola

2021

Dermatol Ther (Heidelb)

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“…Radiography only detects changes at a relatively late stage of disease, such as periosteal bony apposition or bony erosions, and is inferior to MRI in the evaluation of the disease extent and severity ( 63 , 64 ). Scintigraphy has been widely used in the past; however, due to its lack of specificity it has been replaced by MRI and ultrasound (US) ( 65 , 66 ). Despite providing interesting preliminary results ( 67 , 68 ), positron emission tomography (PET) does seem neither specific nor able to offer the same excellent spatial resolution as MRI, requiring further research in this field.…”

Section: Imaging To Differentiate Spa From Fmmentioning

confidence: 99%

The Impact of Fibromyalgia in Spondyloarthritis: From Classification Criteria to Outcome Measures

et al. 2018

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The term spondyloarthritis (SpA) encompasses a broad clinical spectrum characterized by chronic inflammatory conditions affecting the sacroiliac joints, the spine but also peripheral joints and tendons and being additionally associated with the involvement of organs, such as bowel, eye and skin (1). Musculoskeletal pain is a key symptom in SpA. However, although low back pain and/or joint pain are characteristic for SpA, undifferentiated pain at different enthesial sites may also be a concomitant or even the first clinical presentation in some patients (2). In addition, fatigue is another important symptom often reported by patients with SpA, which substantially affects the quality of life (QoL) (3). Fibromyalgia (FM) is the most common diagnosis in patients complaining of chronic diffuse pain with fatigue and may occur alone or in association with chronic inflammatory diseases (4). The prevalence of FM ranges from 2 to 8% in the general population and it can reach up to over 50% in patients with other rheumatic and musculoskeletal diseases (RMDs) (5–7). FM has been identified as the most disabling RMD, based on the patients' perception that their medical condition is not properly recognized (8). This is also due to the poor knowledge about its pathogenesis, and therefore the lack of reliable biomarkers reveals a major unmet need requiring to be addressed in further research studies. Over the last decade, an increasing body of evidence described the impact of FM in SpA highlighting the pitfalls for correct classification, appropriate differential diagnosis and assessment of outcome measures in both conditions. The purpose of this review is to provide an overview of currently available data with regard to the coexistence and reciprocal features of FM and SpA.

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“…Kamanli et al and Said-Nahal et al found higher frequency of HLA-B*35 in HLA-B*27 negative SpA patients [24,25] and genetic research on ancient human remains showed an association of HLA-B*40, HLA-B*27 and HLA-B*35 alleles in individuals with rheumatic diseases, particular in individuals with SpA [26]. This association is based on studies in which sacroiliitis was detected by conventional X-ray but the structural lesions visible on X-ray are a sign of advanced disease and therefore diagnosing with X-rays may delay diagnosis of SpA for seven years [27]. Apart from its inability to detect early sacroilliitis, there is also significant observer variation in reading radiographs of sacroiliac (SI) joints [28].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-Verified Peripheral Arthritis in Patients with HLA-B*35 Positive Spondyloarthritis

Šošo

Aljinović

Kojundžić

et al. 2021

Life

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Background: We aimed to investigate possible association between the HLA-B*35 allele and peripheral arthritis, tenosynovitis and enthesitis. Methods: Ultrasound of peripheral joints and tendons was performed in 72 HLA-B*35 positive patients with preliminary diagnosis of undifferentiated axial form of spondyloarthitis and joint and tendon pain. Patients with other known types of axial and peripheral spondyloarthritis were excluded as well as patients with other known types of arthritis. Results: Pathological changes were found in the joints of 33 (46%) patients and on the tendons in 13 (18%) patients. The most common ultrasound findings were joint effusion and synovial proliferation with positive power Doppler signal grade 1. The most common ultrasound finding in patients with painful tendons was tenosynovitis. A higher disease activity and an increased incidence of elevated CRP (≥5 mg/L) were more often observed in the group with positive ultrasound findings. Conclusion: In this study, we showed that the HLA-B*35 allele could be a potential risk factor for developing peripheral arthritis, but not for tenosynovits and enthesitis in patients with the undifferentiated axial form of spondyloarthritis. This result may influence the follow up of these patients, especially since it gives us an opportunity to consider the use of different types of DMARDs in the treatment of these patients.

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The Role of Imaging in Diagnosing Axial Spondyloarthritis

Cited by 37 publications

References 115 publications

Musculoskeletal Imaging for Dermatologists: Techniques in the Diagnosis and Management of Psoriatic Arthritis

Musculoskeletal Imaging for Dermatologists: Techniques in the Diagnosis and Management of Psoriatic Arthritis

The Impact of Fibromyalgia in Spondyloarthritis: From Classification Criteria to Outcome Measures

Ultrasound-Verified Peripheral Arthritis in Patients with HLA-B*35 Positive Spondyloarthritis

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