ARRS 2022 Abstracts

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E1707. Early and Late Bony Changes of Ankylosing Spondylitis: Multimodality Imaging Review
Authors
  1. Rishabh Gattu; Newark Beth Israel Medical Center
  2. Tejasvi Kainth; Newark Beth Israel Medical Center
  3. Gagandeep Singh; Newark Beth Israel Medical Center
  4. Kenneth Brock; Newark Beth Israel Medical Center
  5. Michael Sadler; Newark Beth Israel Medical Center
  6. John Matthews; Newark Beth Israel Medical Center
Background
The estimated prevalence of axial ankylosing spondylitis (AS) is 0.9% in the age group of 20–60 years. This corresponded to 1.7 million people affected with axial AS in 2009–2010 in the United States. AS most commonly presents in young adults in the third decade of life. Given the relatively high prevalence and morbidity in the young population, recognizing characteristic radiographic findings plays a crucial role in diagnosing AS. Different imaging modalities have been used to monitor disease progression and plan management in patients affected with AS.

Educational Goals / Teaching Points
Our main educational objective is to discuss the presentation of AS on plain radiograph, CT, MRI, and bone scintigraphy. We will highlight early and late presenting features of AS on multi-modality imaging. Teaching points will include differentials, associations, and prognosis associated with AS. We will also discuss treatment modalities and potential complications including fractures and dislocations associated with AS.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We surveyed patients diagnosed with AS at our institution for key radiological presentations on different imaging modalities. We highlight distinguishing characteristics that may help narrow down the diagnosis and provide an insight into pathophysiology, prognosis, and complications using various imaging modalities. We provide a case-based comprehensive review of characteristic radiological features of AS on different imaging modalities. Plain radiography has been used as a gold standard to view gross diagnostic signs like the bamboo spine, which develops late in the course of AS. MRI has been used to diagnose at early stages, whereas CT provides an accurate picture of associated changes in the bones. We will discuss key imaging features of sacroiliac joints, spine, and chest in the early and late presentation of AS.

Conclusion
Characteristic radiological features on different modalities are key to the early diagnosis of Ankylosing Spondylitis and in monitoring disease progression to guide treatment.