These body regions might be evaluated separately or in combination as guided by physical examination findings, patient history, and other available information. Bone Scan with SPECT or SPECT/CT Sacroiliac Joints Bone scintigraphy is not routinely obtained to evaluate for treatment response or disease progression in axSpA patients, and there is no relevant literature supporting its use in this setting. Bone Scan with SPECT or SPECT/CT Sacroiliac Joints and Spine Area of Interest Bone scintigraphy is not routinely obtained to evaluate for treatment response or disease progression in axSpA patients, and there is no relevant literature supporting its use in this setting. CT Sacroiliac Joints CT demonstrates structural changes of the sacroiliac joints in axSpA that may not be apparent on radiographs [22]; however, it is not routinely used for follow-up or assessing disease progression. CT Sacroiliac Joints and Spine Area of Interest CT demonstrates structural changes of the sacroiliac joints in axSpA that may not be apparent on radiographs [22] and can better demonstrate spinal syndesmophyte growth than radiographs using low-dose techniques [49,58]. However, it is not routinely used for follow-up or assessing disease progression. Fluoride PET/CT Skull Base to Mid-Thigh F-18-fluoride PET/CT is not routinely obtained to evaluate for treatment response or disease progression in axSpA patients, and there is no relevant literature supporting its use in this setting. MRI Sacroiliac Joints There is no standard method of following patients with MRI to evaluate for treatment response or disease progression [22,30]. Although multiple studies demonstrate decreasing inflammation on MRI following treatment with TNF-inhibitors, including some long-term studies showing sustained reduction in inflammation, the degree to which MRI findings correlate with disease activity is variable [30].
Inflammatory Back Pain Known or Suspected Axial Spondyloarthropathy PCAs. These body regions might be evaluated separately or in combination as guided by physical examination findings, patient history, and other available information. Bone Scan with SPECT or SPECT/CT Sacroiliac Joints Bone scintigraphy is not routinely obtained to evaluate for treatment response or disease progression in axSpA patients, and there is no relevant literature supporting its use in this setting. Bone Scan with SPECT or SPECT/CT Sacroiliac Joints and Spine Area of Interest Bone scintigraphy is not routinely obtained to evaluate for treatment response or disease progression in axSpA patients, and there is no relevant literature supporting its use in this setting. CT Sacroiliac Joints CT demonstrates structural changes of the sacroiliac joints in axSpA that may not be apparent on radiographs [22]; however, it is not routinely used for follow-up or assessing disease progression. CT Sacroiliac Joints and Spine Area of Interest CT demonstrates structural changes of the sacroiliac joints in axSpA that may not be apparent on radiographs [22] and can better demonstrate spinal syndesmophyte growth than radiographs using low-dose techniques [49,58]. However, it is not routinely used for follow-up or assessing disease progression. Fluoride PET/CT Skull Base to Mid-Thigh F-18-fluoride PET/CT is not routinely obtained to evaluate for treatment response or disease progression in axSpA patients, and there is no relevant literature supporting its use in this setting. MRI Sacroiliac Joints There is no standard method of following patients with MRI to evaluate for treatment response or disease progression [22,30]. Although multiple studies demonstrate decreasing inflammation on MRI following treatment with TNF-inhibitors, including some long-term studies showing sustained reduction in inflammation, the degree to which MRI findings correlate with disease activity is variable [30].