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The Radiological Spectrum of Spinal Arthropathies 2008

General Spine

Marco P Floridia, M.D.,
Yung H Chen, M.D., Non ASSR Member
Steven Lev, M.D., Non ASSR Member
Vinodkumar Velayudhan, D.O., Non ASSR Member

Scientific Poster

Exhibit Panels: 2

Purpose

The spinal arthropathies have variegated yet distinctive imaging appearances. We review the classic radiographic findings as well as discuss some uncommon manifestations of these diverse entities. The key differentiating features are highlighted to assist the radiologist in formulating a precise diagnosis.

Methods & Materials

We retrospectively reviewed imaging studies (plain radiographs, MDCT, and MR) over the last 10 years at our institution and broadly subdivided the spinal arthropathies into inflammatory and degenerative categories. The bony spinal changes are highlighted as well as associated non-osseous abnormalities such as calcification/ossification of the spinal ligaments and soft tissues. When pertinent, we include additional extraspinous supporting images as well as important clinical information to give the viewer a broader scope of the disease processes we discuss.

Results

Inflammatory arthritidies encompasses the seronegative (eg. ankylosing spondylitis), crystal-induced spondyloarthropathies, juvenile and adult rheumatoid arthritis, and assorted metabolic conditions. Crystal-induced spondyloarthropathies include crowned dens syndrome, pseudogout, and calcium hydroxyapatite deposition disease (CPPD). Metabolic disorders include hemodialysis-associated spondyloarthropathy and ochronosis. The degenerative category includes neurogenic (Charcot) arthropathy, degenerative scoliosis, as well as entities that are associated with ligamentous (DISH, OPLL, calcification of the ligamentum flavum) and soft tissue (calcification of the longus colli muscles) calcifications/ossifications.

Conclusion

Evaluation of the spinal arthropathies can be challenging due to the variety of radiologic presentations. An awareness of the typical and unusual imaging findings can help to differentiate these disorders.