US Sacroiliac Joints and Spine Area of Interest US is not suggested as a routine diagnostic modality for the evaluation of sacroiliitis in patients with suspected axSpA because of its lack of established diagnostic utility [22]. Importantly, US provides evaluation 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. In addition to data showing decreased resistive indices at the sacroiliac joints in patients with active sacroiliitis joints [130-132], there is evidence that resistive indices of the thoracolumbar paraspinal areas are also decreased in patients with AS [132]. However, there is not enough evidence to support the use of US for the diagnosis of axSpA. Variant 3: Inflammatory back pain. Suspected axial spondyloarthritis. Negative radiographs and negative MRI of the sacroiliac joints. Next imaging study. The body regions covered in this clinical scenario are the sacroiliac joints, 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. Bone Scan with SPECT or SPECT/CT Spine Area of Interest Bone scintigraphy is not routinely suggested in the evaluation of patients with suspected axSpA because of its lack of established diagnostic utility [22]. Conventional bone scintigraphy has low to moderate sensitivity and variable specificity for the diagnosis of axSpA [41,42,50]. If bone scintigraphy is used, because of the complexity of the spine anatomy, the use of SPECT should be performed during the examination [51].
Inflammatory Back Pain Known or Suspected Axial Spondyloarthropathy PCAs. US Sacroiliac Joints and Spine Area of Interest US is not suggested as a routine diagnostic modality for the evaluation of sacroiliitis in patients with suspected axSpA because of its lack of established diagnostic utility [22]. Importantly, US provides evaluation 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. In addition to data showing decreased resistive indices at the sacroiliac joints in patients with active sacroiliitis joints [130-132], there is evidence that resistive indices of the thoracolumbar paraspinal areas are also decreased in patients with AS [132]. However, there is not enough evidence to support the use of US for the diagnosis of axSpA. Variant 3: Inflammatory back pain. Suspected axial spondyloarthritis. Negative radiographs and negative MRI of the sacroiliac joints. Next imaging study. The body regions covered in this clinical scenario are the sacroiliac joints, 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. Bone Scan with SPECT or SPECT/CT Spine Area of Interest Bone scintigraphy is not routinely suggested in the evaluation of patients with suspected axSpA because of its lack of established diagnostic utility [22]. Conventional bone scintigraphy has low to moderate sensitivity and variable specificity for the diagnosis of axSpA [41,42,50]. If bone scintigraphy is used, because of the complexity of the spine anatomy, the use of SPECT should be performed during the examination [51].