Zeitschrift für Rheumatologie

, Volume 76, Issue 2, pp 149–162 | Cite as

Entzündliche Wirbelsäulenerkrankungen: axiale Spondyloarthritis

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Zusammenfassung

Die Diagnose einer axialen Spondyloarthritis (axSpA) umfasst die klassische ankylosierende Spondylitis (AS), aber auch frühe Phasen der Erkrankung, in denen es noch nicht zu strukturellen Veränderungen gekommen ist. Diese werden als nicht-röntgenologische axSpA (nr-axSpA) klassifiziert. Charakteristisch für die axSpA sind entzündliche Veränderungen im gesamten Achsenskelett, die mit Magnetresonanztomographie (MRT) sichtbar gemacht werden können und, meist später im Verlauf der Erkrankung, kommen bei den meisten Patienten auch strukturelle Veränderungen wie die charakteristische Knochenneubildung mit Syndesmophyten und Ankylosierungen hinzu. Diese knöchernen Veränderungen können am besten durch konventionelle Röntgentechniken oder durch Computertomographie abgebildet werden. Bestimmte MRT-Sequenzen sind heute Standard für die Erfassung entzündlicher Veränderungen. Die Einführung der MRT hat zu einem diagnostischen Paradigmenwechsel geführt, weil die für die Erkrankung charakteristischen entzündlichen Läsionen mit den geeigneten Sequenzen frühzeitig abgebildet werden können.

Schlüsselwörter

Ankylosierende Spondylitis Magnetresonanztomographie Strukturelle Veränderungen Konventionelle Röntgenaufnahmen Computertomographie 

Inflammatory spinal diseases: axial spondyloarthritis

Central importance of imaging

Abstract

The diagnosis of axial spondyloarthritis (axSpA) includes classical ankylosing spondylitis (AS) as well as earlier stages and abortive courses of the disease, in which structural alterations have not yet occurred. These are classified as non-radiographic axSpA (nr-axSpa). Inflammatory changes in the entire axial skeleton are characteristic for axSpA and can be visualized by magnetic resonance imaging (MRI), while in most patients structural alterations, such as new bone formation with syndesmophytes and ankylosis develop in the later course of the disease. These bony alterations can best be visualized by conventional radiography and by computed tomography. Certain MRI sequences are nowadays considered as the standard method for depiction of inflammatory changes in axSpA. The introduction of MRI has led to a paradigm shift for this disease because the inflammatory lesions characteristic for the disease can be visualized at an early stage using appropriate MRI sequences.

Keywords

Ankylosing spondylitis Magnetic resonance imaging Structural alterations Conventional radiographs Computed tomography 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

X. Baraliakos, M. Fruth, U. Kiltz und J. Braun geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Rheumazentrum Ruhrgebiet HerneHerneDeutschland

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