Imaging of seronegative spondyloarthritis

Best Pract Res Clin Rheumatol. 2008 Dec;22(6):1045-59. doi: 10.1016/j.berh.2008.09.006.


Magnetic resonance imaging (MRI) and ultrasonography (US) are useful adjuncts in the diagnosis of seronegative spondyloarthritides (SpA); a group of diseases that present early at a stage when radiographic assessment is invariably normal. This chapter will review how MRI and US can be used in the evaluation of early SpA. The diffuse osteitis/enthesitis on MRI may serve as a diagnostic hallmark for SpA spinal disease, but needs confirmatory studies for comparison with other spinal pathologies. MRI is the modality of choice for monitoring axial disease in anti-tumour necrosis factor (TNF) therapy responses in the research environment, but it is not yet certain whether this will be relevant in clinical practice. Anti-TNF therapy may be associated with regression of MRI-determined osteitis, but retardation of associated bony fusion is debatable. MRI and US are still undergoing evaluation for the diagnosis of enthesitis of the appendicular skeleton; US, in particular, shows promise at these sites.

Publication types

  • Review

MeSH terms

  • Autoantibodies / immunology
  • Early Diagnosis
  • Humans
  • Magnetic Resonance Imaging*
  • Spondylarthritis / blood
  • Spondylarthritis / diagnosis*
  • Ultrasonography / methods*


  • Autoantibodies