CT Spine Area of Interest CT and MRI are the imaging techniques of choice for definitive evaluation of the patient with ankylosis and suspected fracture [22,32]. CT can be performed rapidly in trauma patients and excellently depicts the complex structures of each vertebral column that can injured in this setting [31] and therefore is typically the preferred modality [22]. The sensitivities of CT and MRI for fracture detection are similar in the available small case series, notably with some fractures better detected on CT and some better detected on MRI, suggesting these modalities have a degree of complementary diagnostic utility [34,160,161]. CT, similar to MRI, has higher sensitivity for detection of fracture in the setting of ankylosis than radiographs [31,32,34,161]. The cervical spine is most frequently involved in a fracture [32,33,35]. The presence of two or more fractures is common [160], and therefore, the entire spine should be imaged to both ensure detection of the potential fracture(s) and to detect multilevel involvement [32]. Fluoride PET/CT Skull Base to Mid-Thigh F-18-fluoride PET/CT 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. MRI Spine Area of Interest CT and MRI are the imaging techniques of choice for definitive evaluation of the patient with ankylosis and suspected fracture [22,32]. Technical difficulties can be encountered during an MRI of some patients with spine ankylosis in the acute posttraumatic setting, including inability of patients to remain immobile during the examination, difficulty with coil selection, and motion artifact. These factors combined with varying degrees of spinal deformity and occasional lack of associated bone marrow edema at fracture sites can result in challenging interpretation [160]. Therefore, CT is typically the preferred modality in this setting [22].
Inflammatory Back Pain Known or Suspected Axial Spondyloarthropathy PCAs. CT Spine Area of Interest CT and MRI are the imaging techniques of choice for definitive evaluation of the patient with ankylosis and suspected fracture [22,32]. CT can be performed rapidly in trauma patients and excellently depicts the complex structures of each vertebral column that can injured in this setting [31] and therefore is typically the preferred modality [22]. The sensitivities of CT and MRI for fracture detection are similar in the available small case series, notably with some fractures better detected on CT and some better detected on MRI, suggesting these modalities have a degree of complementary diagnostic utility [34,160,161]. CT, similar to MRI, has higher sensitivity for detection of fracture in the setting of ankylosis than radiographs [31,32,34,161]. The cervical spine is most frequently involved in a fracture [32,33,35]. The presence of two or more fractures is common [160], and therefore, the entire spine should be imaged to both ensure detection of the potential fracture(s) and to detect multilevel involvement [32]. Fluoride PET/CT Skull Base to Mid-Thigh F-18-fluoride PET/CT 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. MRI Spine Area of Interest CT and MRI are the imaging techniques of choice for definitive evaluation of the patient with ankylosis and suspected fracture [22,32]. Technical difficulties can be encountered during an MRI of some patients with spine ankylosis in the acute posttraumatic setting, including inability of patients to remain immobile during the examination, difficulty with coil selection, and motion artifact. These factors combined with varying degrees of spinal deformity and occasional lack of associated bone marrow edema at fracture sites can result in challenging interpretation [160]. Therefore, CT is typically the preferred modality in this setting [22].