Spondyloarthropathy, Pediatric

<bold>FIG. 63.2.</bold> Anteroposterior radiograph of the upper pelvis and lumbar spine. Both sacroiliac joints (<italic>large arrows</bold>) are fused (grade IV sacroiliitis), and there are bilateral, symmetric syndesmophytes (<italic>small arrow</bold>), resulting in the typical "bamboo" appearance of ankylosing spondylitis.

<bold>FIG. 63.3.</bold> Lateral radiograph of the lumbar spine in ankylosing spondylitis with "shiny corners" or Romanus lesions (<italic>large arrows</bold>) due to marginal erosions of verte al bodies and typical marginal syndesmophytes (<italic>small arrows</bold>).

<bold>FIG. 63.4.</bold> Lateral radiograph of the cervical spine in ankylosing spondylitis. Bony fusion of apophyseal joint between C2 and C3 (<italic>large arrow</bold>) and all other apophyseal joints below this level also are fused. A marginal syndesmophyte is also shown (<italic>small arrow</bold>).

<bold>FIG. 65.7.</bold> Family study in which psoriasis, ulcerative colitis, and ankylosing spondylitis showed a "clustering" phenomenon. Patients DB and FB have psoriasis in addition to ankylosing spondylitis.

<bold>Fig B 10-12. Ankylosing spondylitis.</bold> Bilateral symmetric obliteration of the sacroiliac joints with prominent syndesmophytes in the lower lumbar spine.

Figure 6-200 <bold>ANKYLOSING SPONDYLITIS: SACROILIAC JOINTS. Bone Window CT, Axial Sacrum.</bold> Note the widening of the left sacroiliac joint resulting from erosions along the articular surfaces of the ilium and sacrum (<italic>arrow</bold>). <bold><italic>COMMENT:</bold></bold> The early changes associated with the inflammatory arthropathies affecting the sacroiliac joints are better evaluated using CT because of its superior sensitivity over plain film radiography. CT is the imaging modality of choice for evalua...

Figure 10-140 <bold>ANKYLOSING SPONDYLITIS: LUMBAR SPINE. A and B. Bamboo Spine.</bold> Note that complete interbody ankylosis by marginal syndesmophytes produces this distinctive undulating spinal contour.

<bold><italic>Figure 12.11</bold></bold>. Technique for sacroiliac compression test. Excellent first-line test to assess for ankylosing spondylitis.

<bold>FIGURE 26-56. Ankylosing spondylitis.</bold> The vertebrae have been cut longitudinally. The vertebral bodies are square and have lost most of their trabecular bone, owing to osteoporosis from disuse. Bone bridges fuse one vertebral body to the next across the intervertebral disks. Portions of the intervertebral disk are replaced by bone marrow. Bony bridges also fuse the posterior elements <bold><i>(ankylosis)</i></bold>.