A prospective study of early diagnostic investigations in the diagnosis of ankylosing spondylitis

Single-Session Combined Anterior-Posterior Approach for Treatment of Ankylosing Spondylitis with Obvious Displaced Lower Cervical Spine Fractures and Dislocations

For patients with AS and lower cervical spine fractures, surgical methods have mainly included the single anterior approach, single posterior approach, and combined anterior-posterior approach. However, various surgical procedures were utilized because the fractures have not been clearly classified according to presence of displacement in these previous studies. Consequently, controversies have been raised regarding the selection of the surgical procedure. This study retrospective analysis was conducted in 12 patients with AS and lower cervical spine fractures and dislocations and explored single-session combined anterior-posterior approach for the treatment of AS with obvious displaced lower cervical spine fractures and dislocations which has demonstrated advantages such as good stabilization, satisfied fracture healing, and easy postoperative cares. However, to some extent, the difficulty and risk of this approach should be considered. Attention should be paid to the prevention of perioperative complications.

Imaging of seronegative spondyloarthritis

Magnetic resonance imaging (MRI) and ultrasonography (US) are useful adjuncts in the diagnosis of seronegative spondyloarthritides (SpA); a group of diseases that present early at a stage when radiographic assessment is invariably normal. This chapter will review how MRI and US can be used in the evaluation of early SpA. The diffuse osteitis/enthesitis on MRI may serve as a diagnostic hallmark for SpA spinal disease, but needs confirmatory studies for comparison with other spinal pathologies. MRI is the modality of choice for monitoring axial disease in anti-tumour necrosis factor (TNF) therapy responses in the research environment, but it is not yet certain whether this will be relevant in clinical practice. Anti-TNF therapy may be associated with regression of MRI-determined osteitis, but retardation of associated bony fusion is debatable. MRI and US are still undergoing evaluation for the diagnosis of enthesitis of the appendicular skeleton; US, in particular, shows promise at these sites.

Spondyloarthropathies: ankylosing spondylitis and psoriatic arthritis

As advances in the treatment of ankylosing spondylitis continue, TNF-alpha blocking agents may eventually be used as a first-line treatment. MR imaging could then be used to aid in the early diagnosis of ankylosing spondylitis by identifying early sacroiliitis, followed by immediate initiation of treatment to prevent the progression of the disease with its accompanying morbidities. Currently, radiographic identification of sacroiliitis remains the mainstay in diagnosing ankylosing spondylitis. In ankylosing spondylitis and psoriasis, MR imaging can demonstrate areas that are undergoing active inflammatory changes and enthesitis, aiding in the diagnosis of a spondyloarthropathy.