Importantly, a US evaluation is limited to the superficial posterior margins of the sacroiliac joints and spine, and therefore many structural details are not demonstrated. Many of the available studies examine the utility of Doppler evaluation. There is evidence in small studies that Doppler resistive indices at the sacroiliac joints increase following treatment with TNF-inhibitors [132,158,159], although more data are necessary to justify the routine use of US in this setting. US Sacroiliac Joints and Spine Area of Interest US of the sacroiliac joints is not utilized as a routine diagnostic tool in the assessment of treatment response or disease progression. Importantly, an US evaluation is limited to the superficial posterior margins of the sacroiliac joints and spine, and therefore many structural details are not demonstrated. Many of the available studies examine the utility of Doppler evaluation. There is evidence in small studies that Doppler-resistive indices at the sacroiliac joints increase following treatment with TNF-inhibitors [132,158,159], and there is limited data showing potentially similar findings in thoracolumbar paraspinal spondylitis [132], although more data are necessary to justify routine use of US in this setting. Variant 5: Axial spondyloarthritis with spine ankylosis. Suspected fracture. Initial imaging. The body regions covered in this clinical scenario are the cervical, thoracic, and lumbar spine. These body regions might be evaluated separately or in combination as guided by physical examination findings, patient history, and other available information. Inflammatory Back Pain Bone Scan with SPECT or SPECT/CT Spine Area of Interest Bone scintigraphy is not routinely obtained to evaluate for suspected fracture in axSpA patients with spine ankylosis, and there is no relevant literature supporting its use in this setting.
Inflammatory Back Pain Known or Suspected Axial Spondyloarthropathy PCAs. Importantly, a US evaluation is limited to the superficial posterior margins of the sacroiliac joints and spine, and therefore many structural details are not demonstrated. Many of the available studies examine the utility of Doppler evaluation. There is evidence in small studies that Doppler resistive indices at the sacroiliac joints increase following treatment with TNF-inhibitors [132,158,159], although more data are necessary to justify the routine use of US in this setting. US Sacroiliac Joints and Spine Area of Interest US of the sacroiliac joints is not utilized as a routine diagnostic tool in the assessment of treatment response or disease progression. Importantly, an US evaluation is limited to the superficial posterior margins of the sacroiliac joints and spine, and therefore many structural details are not demonstrated. Many of the available studies examine the utility of Doppler evaluation. There is evidence in small studies that Doppler-resistive indices at the sacroiliac joints increase following treatment with TNF-inhibitors [132,158,159], and there is limited data showing potentially similar findings in thoracolumbar paraspinal spondylitis [132], although more data are necessary to justify routine use of US in this setting. Variant 5: Axial spondyloarthritis with spine ankylosis. Suspected fracture. Initial imaging. The body regions covered in this clinical scenario are the cervical, thoracic, and lumbar spine. These body regions might be evaluated separately or in combination as guided by physical examination findings, patient history, and other available information. Inflammatory Back Pain Bone Scan with SPECT or SPECT/CT Spine Area of Interest Bone scintigraphy is not routinely obtained to evaluate for suspected fracture in axSpA patients with spine ankylosis, and there is no relevant literature supporting its use in this setting.