Presentation
HLA-B27 positive patient with pain during prolonged standing and difficulty climbing stairs.
Patient Data
Subchondral sclerosis and multiple erosions with the joint space widening.
There are edema, erosion and contrast enhancement in the joint space and surrounding bone. The joint space is widened with fatty deposition in bone marrow. The changes are bilateral.
Signs of disease activity: sacroiliitis of Grade 3.
Case Discussion
MRI is superior to radiography to detect early sacroiliitis because it can show active inflammation before structural damage occurs. MRI also shows structural changes in the form of erosion and alteration of joint space as well as fat deposition in the bone marrow; it is therefore appropriate for monitoring the activity of the disease and for the indication for treatment and for evaluating the effect of the therapy.
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