Progress in spondylarthritis. Spondyloarthritis lessons from imaging 英文参考文献.docVIP

Available online /content/11/3/222 Review Progress in spondylarthritis Spondyloarthritis: lessons from imaging Walter P Maksymowych1,2 1Department of Medicine, 562 Heritage Medical Research Building, University of Alberta, Edmonton, Alberta T6G 2S2, Canada 2Alberta Heritage Foundation for Medical Research, Alberta, Canada Corresponding author: Walter P Maksymowych, walter.maksymowych@ualberta.ca Published: 18 May 2009 Arthritis Research Therapy 2009, 11:222 (doi:10.1186/ar2665) This article is online at /content/11/3/222 ? 2009 BioMed Central Ltd Abstract pathophysiology of disease? How does each method facilitate evaluation of patients presenting early in their disease course? What are the advantages and limitations of outcome assessment tools developed for each method? The advent of magnetic resonance imaging (MRI) and advanced sonographic techniques has led to a resurgence of interest in the role of imaging in the evaluation and management of spondylo- Radiography remains the cornerstone of diagnosis arthritis. although MRI is more sensitive in early stages of the disease. Inflammatory changes in the sacroiliac joints and spine can now be reliably quantified and can also predict the subsequent develop- ment of radiographic changes in the corresponding locations. MRI- based scoring systems for inflammation are highly responsive, facilitating proof-of-concept studies of new therapies for spondylo- arthritis. Assessment of chronic changes is much less reliable using MRI, while assessment using radiography lacks sensitivity to change. Assessment of disease modification therefore remains a principle challenge in the development of new therapies for ankylosing spondylitis. Ultrasound may be the preferred approach to the assessment of peripheral inflammation, especially enthesitis. Scintigraphy and computed tomography offer few advantages over MRI. Clarifyi