Radiology 2A Week 8

What are the AKAs of Ankylosing spondylitis?

Bechterew's Disease

Marie Strumpell Disease

What part of the skeleton is involve in Ankylosing Spondylitis?

Axial

What demographic is most affected by AS?

Males

Age 15-35

What are the extra-skeletal features of AS?

Iritis

Aortitis

Renal failure

What are the trademark lab findings of AS?

+ HLA-B27 (90%)

Rheumatoid factor negative

elevated ESR

What is the term for an inflammatory change at a ligamentous attachment?

Enthesopathy

What is the finding of AS at the SI joint?

Bilaterally symmetrical sacroiliitis

What direction does AS move in the spine?

Starts at the bottom and moves upwards

Which joints of the spine are spared in AS?

None

What is the greatest complicating factor for patients with AS?

Osteoporosis (due to lack of bone movement)

What is the term for undulating appearance of the SI joint due to erosions in AS?

Rosary bead erosions

What is the term for fusion of the SI joints with visualization of the articular cortex in AS?

Ghost joint

What is the term for ossification of the superior SI ligaments, creating a triangular radiopacity in AS?

Star sign

What is the term for undulating and segmented appearance of the spine owing to uniform and symmetric bridging syndesmophytes?

Bamboo spine

What is the AKA of bamboo spine?

Poker spine

What is the term for vertical linear regions of increased radiopacity on AP lumbar X-ray in AS?

Trolley track / dagger sign

What joints are affected with trolley track sign?

Facet joints

What ligaments are affected with dagger sign?

Interspinous and supraspinous

What is the term for an erosion at the anterior vertebral body margin at annular insertion in AS?

Romanus lesion

What is Romanus Lesion a precursor of?

Syndesmophyte formation

What is the term for transient reactive sclerosis adjacent to a Romanus lesion?

Shiny corner sign

What is the term applied to a fracture that occurs through an ankylosed segment to amplify the brittleness of the spine?

Carrot stick fracture

What is the AKA of carrot stick fracture?

Chalk stick fracture

What is the term for a single mobile segment in AS which results in instability and adjacent destruction that simulates infection or NA?

Andersson's lesion

What are the early findings of AS?

Widened SI joint

Frayed SI joint margin

Sclerosis on the iliac side of the SI joints

Which Seronegative arthropathies produce marginal syndesmophyes?

AS and EA

Which condition is AS identical to on X-ray?

EA

What is the only distinguishing factor between AS and EA?

History (gut involvement with EA)

What is the term for the group of arthritis diseases with gastrointestinal origin?

Enteropathic arthritis

What are the most common causes of EA?

Ulcerative colitis (10% of UC patients get EA)

Regional enteritis (crohn's disease)

What are other less common causes of EA?

Collagenous colitis

Whipple's disease

Intestinal infection (salmonella, shigella, yersinia)

What are the AKAs of EA?

Enteropathic arthropathy

Enteropathic spondylitis

What is the most common demographic of EA?

Young adults

What is the finding of EA at the SI joint?

Bilaterally symmetrical fusion

What is the term for lucency of the transverse colon found in EA as seen on x-ray?

Lead pipe sign