Fast Five Quiz: Ankylosing Spondylitis Management

Herbert S. Diamond, MD


June 29, 2020

Figure 1. Colored radiograph of the thoracic and lumbar spine in a patient with ankylosing spondylitis.

Radiography is the single most important imaging technique for the detection, diagnosis, and follow-up monitoring of patients with ankylosing spondylitis. Overall bony morphology and subtle calcifications and ossifications may be demonstrated well radiographically.

CT is useful in some situations (eg, in equivocal cases of sacroiliitis and cases in which subtle radiographic changes are present) and in the evaluation of complications. Although CT is useful in evaluating sacroiliitis, normal variations of the sacroiliac joints may simulate the findings of inflammation. Because of its high radiation dose, CT is not ideal for imaging long segments of the spine.

MRI of the sacroiliac joints is considered an alternative in some cases, such as in young patients and those with a short duration of symptoms.

Ultrasound helps identify the anatomical landmarks in patients with ankylosing spondylitis before regional anesthesia and makes it easier to perform the blockade with a minimal number of attempts. It may also be used for assessing spinal mobility.

Learn more about imaging techniques used in AS.


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