Imaging in juvenile spondyloarthritis

Imaging may play an important role in Juvenile Spondyloarthritis. It can be indicated to aid in diagnosis, exclude alternative diagnoses, assess treatment response and detect potential complications. The primary goal of imaging has shifted from detecting damage to detecting early inflammatory changes, since the advent of newer therapeutic agents have made early suppression of inflammatory changes to prevent irreversible damage the main clinical goal. Although conventional radiography still remains a standard, it mainly visualizes late inflammatory stages and complications, but lacks sensitivity in early-stage disease. Ultrasonography is the first imaging modality of choice to detect early inflammation in smaller joints, or when multiple joints are affected. Magnetic Resonance Imaging (MRI) is the imaging modality of choice for complex joints such as spine, temporomandibular and sacroiliac joints. MRI is excellent for demonstrating early changes, depicting not only bone marrow oedema but also soft tissue inflammation and joint effusion/bursitis