The spine can be involved in most inflammatory disorders encompassing rheumatoid arthritis (RA), seronegative spondyloarthritides (SpA), juvenile arthritides and less frequent disorders such as pustulotic arthro-osteitis and SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome.ĭuring the last decade the diagnostic use of magnetic resonance imaging (MRI) and computed tomography (CT) has increased considerably, although radiography is still the recommended initial examination. MRI can detect signs of active inflammation as well as chronic structural changes CT is valuable for detecting fracture. The imaging features of the other forms of SpA can vary, but voluminous paravertebral ossifications often occur in psoriatic SpA. In early stages it is characterised by vertebral squaring and condensation of vertebral corners, in later stages by slim ossifications between vertebral bodies, vertebral fusion, arthritis/ankylosis of apophyseal joints and ligamentous ossification causing spinal stiffness. Ankylosing spondylitis is the most frequent form of SpA and has rather characteristic radiographic features. Subluxation is diagnosed by radiography, but supplementary MRI and/or CT is always indicated to visualise the spinal cord and canal in patients with vertical subluxation, neck pain and/or neurological symptoms. RA changes are usually located in the cervical spine and can result in serious joint instability. The purpose of this review is to present the typical radiographic features of spinal changes in RA and SpA in addition to the advantages of MRI and CT, respectively.

Thus, MRI and CT are increasingly used, although radiography is the recommended initial examination. Spinal involvement is frequent in rheumatoid arthritis (RA) and seronegative spondyloarthritides (SpA), and its diagnosis is important.

Cervical spine x ray