Color and duplex Doppler sonography to detect sacroiliitis and spinal inflammation in ankylosing spondylitis. Can this method reveal response to anti-tumor necrosis factor therapy?

• Published in: Journal of rheumatology Vol. 34; no. 1; pp. 110 - 116
• Main Authors: ÜNLÜ, Ercüment, PAMUK, Ömer Nuri, CAKIR, Necati
• Format: Journal Article
• Language: English
• Published: Toronto, ON The Journal of Rheumatology 01-01-2007; Journal of Rheumatology Publishing
• Subjects: Adult; Antibodies, Monoclonal - therapeutic use; Antirheumatic Agents - therapeutic use; Arthritis - diagnostic imaging; Arthritis - etiology; Arthritis - pathology; Biological and medical sciences; Cardiovascular system; Case-Control Studies; Diseases of the osteoarticular system; Diseases of the spine; Etanercept; Female; Humans; Immunoglobulin G - therapeutic use; Inflammation - diagnostic imaging; Inflammation - etiology; Inflammation - pathology; Inflammatory joint diseases; Infliximab; Investigative techniques, diagnostic techniques (general aspects); Lumbar Vertebrae - blood supply; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - pathology; Male; Medical sciences; Middle Aged; Receptors, Tumor Necrosis Factor - therapeutic use; Sacroiliac Joint - blood supply; Sacroiliac Joint - diagnostic imaging; Sacroiliac Joint - pathology; Sensitivity and Specificity; Spondylitis, Ankylosing - complications; Spondylitis, Ankylosing - diagnostic imaging; Spondylitis, Ankylosing - drug therapy; Spondylitis, Ankylosing - pathology; Thoracic Vertebrae - blood supply; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - pathology; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Ultrasonic investigative techniques; Ultrasonography, Doppler, Color; Ultrasonography, Doppler, Duplex; Doppler ultrasound study; Spondyloarthropathy; Lumbar spine; Sacro-iliitis; Spine; Diseases of the osteoarticular system; Vertebra; Inflammatory joint disease; Spine disease; Duplex ultrasonography; Spondylarthropathy; Blood vessel; Tumour necrosis factor α inhibitor; Ankylosing spondylitis; Sonography; Treatment efficiency; Inflammation; Joint; Artery; Chemotherapy; Chronic; Treatment; Tumor necrosis factor; COLOR AND DUPLEX DOPPLER ULTRASONOGRAPHY ANKYLOSING SPONDYLITIS TUMOR NECROSIS FACTOR INHIBITOR SACROILIITIS; Medical imagery
• ISSN: 0315-162X; 1499-2752

OBJECTIVE: To investigate the role of color and duplex Doppler ultrasound (CDDUS) in the detection of sacroiliac (SI) and
spinal inflammation, as well as response to anti-tumor necrosis factor (TNF) therapy in patients with ankylosing spondylitis
(AS). METHODS: We included 39 consecutive patients with AS followed at our center and 14 healthy controls. In the AS and control
groups, blood vessels in SI joints and lumbar vertebral (LV) and thoracal vertebral (TV) paraspinal areas were investigated
by CDDUS. When the artery was found, the resistive index (RI) was measured by CDDUS. Disease activity characteristics (ESR,
CRP, BASDAI, and BASMI) were evaluated in patients with AS. In 11 patients for whom anti-TNF therapy was indicated, CDDUS
measurements were performed before and on Week 12 of therapy. RESULTS: In patients with AS, RI values of SI joints and of
LV and TV areas were lower than in controls (all p < or = 0.01). In AS patients with active disease according to BASDAI, RI
values of TV (p = 0.0013) and LV (p = 0.027) were significantly lower than in the inactive group. In the group with active
AS, SI RI was nonsignificantly lower (p = 0.16). After anti-TNF therapy, there were significant increases in mean SI RI (p
= 0.028) and LV RI (p = 0.039), and a nonsignificant increase in TV RI (p > 0.05). CONCLUSION: CDDUS may be an alternative,
less expensive, and easier method for detecting inflammation secondary to increased SI and spinal vascularization and in evaluating
response to anti-TNF therapy in AS.