Imaging of Spine Disease: Look to MRI, says EULAR

Posted by: MollyC1i

Imaging of Spine Disease: Look to MRI, says EULAR - 06/29/15 07:33 AM

http://www.medpagetoday.com/Rheumatology/BackPain/52341?xid=nl_mpt_DHE_2015-06-29&eun=g595346d0r

06.27.15 RHEUMATOLOGY
Imaging of Spine Disease: Look to MRI, says EULAR

The European League Against Rheumatism (EULAR) has released a new set of recommendations on imaging for the diagnosis and monitoring of patients with spondyloarthritis (SpA), emphasizing the importance of MRI for early diagnosis.
"Significant advances have been made within the field of imaging in SpA over the past decade," wrote Peter Mandl, MD, PhD, of the University of Vienna, and colleagues from the EULAR task force.
"Conventional radiography only visualizes the late structural consequences of the inflammatory process, while the early inflammatory changes can be detected by MRI, often several years before the appearance of sacroiliitis on radiography," the authors wrote in the July Annals of the Rheumatic Diseases.
The urgency for these recommendations has been heightened by advances in treatment and the greater understanding that early intervention can help prevent the most devastating consequences and long-term damage associated with SpA. (more...)

(snip...) "We aimed to produce recommendations that are practical and valuable in daily practice for rheumatologists, radiologists, and general practitioners," Mandl and colleagues concluded.

cat

Still smile (grimly) on recollecting the pronouncement from a past `President`! of EULAR that radios were the first `go-to` modality in Dx AS. He has had to eat his words ever since...
Posted by: MollyC1i

Re: Imaging of Spine Disease: Look to MRI, says EULAR - 06/30/15 11:47 AM

Has to be a good MRI. Fat suppression, T1, T2, STIR sequences. Here is some good basic information - https://www.ole.bris.ac.uk/bbcswebdav/in...ial/page_04.htm

BTW, will need the T1 as it picks up the bone marrow and T2 oedema.

Also, will need a good referral from advising physician. Not much good asking for MRI of spine ! Needs to indicate `what` is being looked for ! In addition, best to image the whole spine, cervical, thoracic, lumbar, sacrum then, sacroiliac. Get the whole thing. Yes, a tad on the expensive side...not too many physicians will call it *all up, or, having called, the radiology dept (or hospital) may refuse a couple, or one section, of.

Suggest that you go back and find out what was ordered up and what was done !
Posted by: MollyC1i

Re: Imaging of Spine Disease: Look to MRI, says EULAR - 07/01/15 03:23 AM

Excellent - a proper job then. It`s wretched not having a iagnosis, frustrating to say the least.

Whereabouts are you based ?
Posted by: MollyC1i

Re: Imaging of Spine Disease: Look to MRI, says EULAR - 07/01/15 06:42 AM

Thought you might be UK. Suggest a second opinion, Can highly recommend Dr Millicent Stone, heads the NHS rheumy dept London Bridge Hospital -
"Dr Stone is working as part of the TWIN research Unit in London, with Professor Spector and his team at St Thomas Hospital. She also holds clinics at The Physicians Clinic, London and The London Bridge Hospital."
Dr Stone holds a pvt clinic - 13 - 14 Devonshire Street, London, W1G 7AE
Further information, see https://www.myhealthspecialist.com/patient/specialist/169/ (and)
http://www.millicentstone.co.uk/physiciansclinic.htm (and)
Dr Millicent Stone: Consultant Rheumatologist – London Bridge ...
www.londonbridgehospital.com/LBH/consultant.../dr-millicent-sto... - Similarto Dr Millicent Stone: Consultant Rheumatologist – London Bridge ...
Dr. Millicent Stone is a Consultant Rheumatologist working at The London Bridge Hospital and The Physicians Clinic part of Harley Street Clinic. Her NHS base ...

Superb rheumatologist - and terrif with her patients. Has a special interest in AS. She was strongly involved in the development of the BASDAI diagnostic protocol.

Dr Stone is also very involved with the eye conditions that all too often afflict AS`ers, see -
Moorfields Eye Hospital added 7 new photos.
11 June at 17:14 ·
A new Inflammation and Uveitis Eye Care (I&U) programme is underway at Moorfields City Road.
The programme involves a multi-disciplinary team who manage the collective needs of patients with inflammatory eye disease and is led by Consultant rheumatologist Dr Millicent Stone.
Dr Stone is a joint appointment between Moorfields Eye Hospital and Guy’s & St Thomas’ rheumatology department and the Medical Eye Unit at St Thomas’. ...
See More https://www.facebook.com/MoorfieldsEyeHospital

More than most other rheumatologists, she not only *really knows her stuff but is great with patients.
Posted by: MollyC1i

Re: Imaging of Spine Disease: Look to MRI, says EULAR - 07/01/15 08:54 AM

Yes, indeed. An expert, but don`t think she is a specific *specialist in AS, though assuredly has an impressive background Stone`s sub-speciality is AS. She has over 600 published papers to her name, and is now strongly involved in the uveitis scene with Moorfields.
Dr M Stone | Kings College Hospital - Dr Millicent Stone
www.millicentstone.co.uk/kings.htm
Dr Stone holds an academic position of Honorary Senior Lecturer at King's ... with over 60 groups worldwide and the publication of 600 research papers.

Two very impressive rheumatologists.
Posted by: MollyC1i

Re: Imaging of Spine Disease: Look to MRI, says EULAR - 07/01/15 04:05 PM

A right bummer - wish you well in working it all out -