MRI manifestations of juvenile-onset ankylosing spondylitis_West China Medical Journal

Authors：

 WU Junhua , ZHANG Dezhou , CHEN Junrong , YI Xuebing

Department of Radiology, Sichuan Provincial Orthopaedic Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

WU Junhua, Email: 13980507619@163.com

Keywords：

Juvenile-onset; Ankylosing spondylitis; Magnetic resonance imaging

DOI：

10.7507/1002-0179.201508062

Video：

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Objective To explore the MRI features of juvenile-onset ankylosing spondylitis (JoAS) for improving the level of diagnosis and therapy. Methods MRI findings of JoAS in 25 patients confirmed by clinical and laboratory results between October 2010 and September 2014 were retrospectively analyzed. Results There were a total of 67 locations of lesion in the 25 cases, including 19 in sacroiliac joint, 21 in hip joint, 6 in ischial tuberosity, 6 in crista iliaca, 9 in knee joint, 4 in ankle joint, and 2 in foot. MRI showed 63 locations with bone marrow edema, 36 with joint effusion, 26 with bone destruction, and 19 with enthesitis. Conclusions Bone marrow edema is the most common MRI manifestation of JoAS, and the main bone destruction is middle axis joint. MRI is sensitive but not specific to lesions, so differential diagnosis is needed and helpful.

Citation： WU Junhua, ZHANG Dezhou, CHEN Junrong, YI Xuebing. MRI manifestations of juvenile-onset ankylosing spondylitis. West China Medical Journal, 2017, 32(9): 1405-1408. doi: 10.7507/1002-0179.201508062 Copy

1.	Burgos-Vargas R, Pacheco-Tena C, Vázquez-Mellado J. Juvenile-onset spondyloarthropathies. Rheum Dis Clin North Am, 1997, 23(3): 569-598.
2.	Gensler LS, Ward MM, Reveille JD, et al. Clinical, radiographic and functional differences between juvenile-onset and adult-onset ankylosing spondylitis: results from the PSOAS cohort. Ann Rheum Dis, 2008, 67(2): 233-237.
3.	黄振国, 张雪哲, 洪闻, 等. 早期强直性脊柱炎骶髂关节病变的 X 线、CT 和 MRl 对比研究. 中华放射学杂志, 2011, 45(11): 1040-1044.
4.	Jaremko JL, Liu L, Winn NJ, et al. Diagnostic utility of magnetic resonance imaging and radiography in juvenile spondyloarthritis: evaluation of the sacroiliac joints in controls and affected subjects. J Rheumatol, 2014, 41(5): 963-970.
5.	施桂英. 幼年强直性脊柱炎及幼年类风湿性关节炎. 中华内科杂志, 1990, 29(12): 710.
6.	Van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum, 1984, 27(4): 361-368.
7.	Rudwaleit M, Van Der Heijde D, Landewé R, et al. The assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis, 2011, 70(1): 25-31.
8.	朱振军, 程田, 李碧波. 人类白细胞抗原-B27 与强直性脊柱炎的相关性分析. 中国实用医刊, 2010, 37(17): 10-11.
9.	Allen RL, Bowness P, McMichael A. The role of HLA-B27 in spondyloarthritis. Immunogenetics, 1999, 50(3-4): 220-227.
10.	Glasnović M, Bosnjak I, Sram M, et al. Clinical characteristics of patients with spondyloarthritides and HLA-B27 positive antigen. Coll Antropol, 2011, 35(2): 397-402.
11.	Maksymowych WP, lnman RD, Salonen D, et al. Spondyloarthritis Research Consortium of Canada magnetic resonance imaging index for assessment of spinal inflammation in ankylosing spondylitis. Arthritis Rheum, 2005, 53(4): 502-509.
12.	Rudwaleit M, Van Der Heijde D, Landewé R, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part Ⅱ): validation and final selection.Arthritis 2009, 68(6): 777-783.
13.	孔庆聪, 邵硕, 刘卫敏, 等. 磁共振联合 HLA-B27 诊断早期强直性脊柱炎的应用价值. 实用放射学杂志, 2012, 28(7): 1083-1086.
14.	Puhakka KB, Jurik AG, Schiottz-Christensen B, et al. Magnetic resonance imaging of sacroiliitis in early seronegative spondylarthropathy. Abnormalities correlated to clinical and laboratory findings. Rheumatology (Oxford), 2004, 43(2): 234-237.
15.	许开喜, 陈新建, 王金, 等. 早期强直性脊柱炎骶髂关节病变低场 MRI 诊断. 实用放射学杂志, 2012, 28(2): 240-243.
16.	Johnson K, Gardner-Medwin J. Childhood arthritis: classification and radiology. Clin Radiol, 2002, 57(1): 47-58.
17.	Cellerini M, Salti S, Trapani S, et al. Correlation between clinical and ultrasound assessment of the knee in children with mono-articular or pauci-articular juvenile rheumatoid arthritis. Pediatr Radiol, 1999, 29(2): 117-123.
18.	金红花, 程若勤, 王化敏, 等. 强直性脊柱炎所致活动性附着点炎的 MRI 分析. 放射学实践, 2013, 28(10): 1066-1068.

1. Burgos-Vargas R, Pacheco-Tena C, Vázquez-Mellado J. Juvenile-onset spondyloarthropathies. Rheum Dis Clin North Am, 1997, 23(3): 569-598.
2. Gensler LS, Ward MM, Reveille JD, et al. Clinical, radiographic and functional differences between juvenile-onset and adult-onset ankylosing spondylitis: results from the PSOAS cohort. Ann Rheum Dis, 2008, 67(2): 233-237.
3. 黄振国, 张雪哲, 洪闻, 等. 早期强直性脊柱炎骶髂关节病变的 X 线、CT 和 MRl 对比研究. 中华放射学杂志, 2011, 45(11): 1040-1044.
4. Jaremko JL, Liu L, Winn NJ, et al. Diagnostic utility of magnetic resonance imaging and radiography in juvenile spondyloarthritis: evaluation of the sacroiliac joints in controls and affected subjects. J Rheumatol, 2014, 41(5): 963-970.
5. 施桂英. 幼年强直性脊柱炎及幼年类风湿性关节炎. 中华内科杂志, 1990, 29(12): 710.
6. Van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum, 1984, 27(4): 361-368.
7. Rudwaleit M, Van Der Heijde D, Landewé R, et al. The assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis, 2011, 70(1): 25-31.
8. 朱振军, 程田, 李碧波. 人类白细胞抗原-B27 与强直性脊柱炎的相关性分析. 中国实用医刊, 2010, 37(17): 10-11.
9. Allen RL, Bowness P, McMichael A. The role of HLA-B27 in spondyloarthritis. Immunogenetics, 1999, 50(3-4): 220-227.
10. Glasnović M, Bosnjak I, Sram M, et al. Clinical characteristics of patients with spondyloarthritides and HLA-B27 positive antigen. Coll Antropol, 2011, 35(2): 397-402.
11. Maksymowych WP, lnman RD, Salonen D, et al. Spondyloarthritis Research Consortium of Canada magnetic resonance imaging index for assessment of spinal inflammation in ankylosing spondylitis. Arthritis Rheum, 2005, 53(4): 502-509.
12. Rudwaleit M, Van Der Heijde D, Landewé R, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part Ⅱ): validation and final selection.Arthritis 2009, 68(6): 777-783.
13. 孔庆聪, 邵硕, 刘卫敏, 等. 磁共振联合 HLA-B27 诊断早期强直性脊柱炎的应用价值. 实用放射学杂志, 2012, 28(7): 1083-1086.
14. Puhakka KB, Jurik AG, Schiottz-Christensen B, et al. Magnetic resonance imaging of sacroiliitis in early seronegative spondylarthropathy. Abnormalities correlated to clinical and laboratory findings. Rheumatology (Oxford), 2004, 43(2): 234-237.
15. 许开喜, 陈新建, 王金, 等. 早期强直性脊柱炎骶髂关节病变低场 MRI 诊断. 实用放射学杂志, 2012, 28(2): 240-243.
16. Johnson K, Gardner-Medwin J. Childhood arthritis: classification and radiology. Clin Radiol, 2002, 57(1): 47-58.
17. Cellerini M, Salti S, Trapani S, et al. Correlation between clinical and ultrasound assessment of the knee in children with mono-articular or pauci-articular juvenile rheumatoid arthritis. Pediatr Radiol, 1999, 29(2): 117-123.
18. 金红花, 程若勤, 王化敏, 等. 强直性脊柱炎所致活动性附着点炎的 MRI 分析. 放射学实践, 2013, 28(10): 1066-1068.

West China Medical Journal

MRI manifestations of juvenile-onset ankylosing spondylitis

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