MRI appearances of inflammatory vertebral osteitis in early ankylosing spondylitis.
BACKGROUND
Undiagnosed and early ankylosing spondylitis (AS), especially in adolescent patients suffering from back pain, may present with the finding of vertebral osteitis on MRI.


OBJECTIVE
To identify the early MRI changes of vertebral osteitis in AS.


METHODS
Five patients (three boys, two girls) aged 11-20 years (mean 15.4 years) suffering from back pain underwent MRI of the thoracolumbar spine. There was no initial diagnosis of AS. After clinical and radiological suspicion of AS, MRI of the sacroiliac (SI) joints was performed.


RESULTS
During the course of AS, destructive and reactive changes affect the discovertebral junctions that are initially seen in the thoracolumbar area. At this stage plain radiography of the spinal column may be normal. On MR images, inflammatory osteitis of the vertebrae is seen as hypointense areas on T1-weighted images and hyperintense areas on T2-W images. The lesions enhance homogenously with contrast material.


CONCLUSIONS
Awareness of the MRI appearances of vertebral osteitis is helpful in suspecting AS. Radiological examination of the SI facilitates the diagnosis and unnecessary further imaging can be avoided.
Kurugoglu
Sebuh
S
Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Turkey. sebuh.k@superonline.com
Kanberoglu
Kaya
K
Kanberoglu
Ayfer
A
Mihmanli
Ismail
I
Cokyuksel
Oktay
O
D000293:Adolescent; D000328:Adult; D001416:Back Pain / Q000209:etiology; D002648:Child; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010000:Osteitis / Q000150:complications* / Q000175:diagnosis*; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000175:diagnosis*; D013904:Thoracic Vertebrae / Q000473:pathology
D003287:Contrast Media