الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Seronegative spondylarthropathies (SpA) are group of diseases that often affect people in young adulthood causing variable degrees of disabilities and affecting significantly their quality of life.
Thus, early diagnosis is essential for a proper and timely treatment. MRI has shown promising achievements in early diagnosis. Furthermore, rheumatologists now have tumor necrosis factor (TNF)-α inhibitors; a more effective therapy; to influence the course of the disease.
The aim of this work was to review the published data about the spinal and sacroiliac joints changes in seronegative patients using MRI and plain radiography as well as emphasize the role of MRI in distinguishing between active and inactive disease and in determining whether these findings correlate with laboratory markers of clinical activity, disease duration, and degree of radiographic damage.
This study included 10 patients with seronegative spondyloarthropathy (SpA) fulfilling the European SpA Study Group Criteria ESSG.
The selected patients were subjected to full history, laboratory investigations, thorough clinical examination, plain radiography and MRI of the lumbo-sacral spines and sacroiliac joints.
The lumbosacral spine and sacroiliac joints were examined using Plain radiography and different MRI sequences. The lumbosacral spine was examined using only the sagittal plane while the sacroiliac joints were examined using both the coronal and axial oblique planes. It was found that the inflammatory changes were only detected using MRI and that chronic changes were equally detected by plain and MRI except for syndesmophytes that were better demonstrated in radiographs because of its higher spatial resolution.
From this study, we can clearly demonstrate that MRI is the best tool in diagnosing inflammatory changes in seronegative spondyloarthropathy patients whether early or on top of chronic changes, and hence directing the clinician for early treatment in cases where inflammatory changes are the sole finding or modifying the treatment in chronic patients where inflammation still exists. In addition, MRI detected chronic changes almost as equal as plain radiography
Owing to the high cost and low availability of MRI, this tool should not be used as a screening method for back pain, but, as a confirmatory method in symptomatic patients with normal plain radiography and patients with persistent symptoms inspite of treatment.