Clinical - additional investigations

Question 1

Xray findings - AnkSpond (SI Joints)

Answer 1

CAJE

1. Cortical outline lost (earliest)
2. Ankylosis of the joint (last after joint space narrows)
3. Juxta-articular osteosclerosis (early)
4. Erosions (early)

Question 2

Xray findings - AnkSpond (lumbar spine)

Answer 2

SSSBA

1. Squaring
2. Shiny corner / Romanus lesion (enthesial site, BM oedema)
3. Syndesmophytes (calcification/ossification in spinal ligament)
4. Bridging (of syndesmophytes - vertebrae)
5. Ankylosis/ Apophyseal facet joint fusion

Question 3

MRI findings (Ank Spond)

Answer 3

• Subchondral BM oedema at vertebral corners (STIR, T2) - active
• Erosions, spondylodiscitis etc (T1) - chronic (post-inflam lesion)
• Ankylosis