Which radiographic findings are characteristic of reactive arthritis (ReA)?

Updated: Dec 24, 2020
  • Author: Carlos J Lozada, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Spinal radiographic findings include sacroiliitis and syndesmophytes. Sacroiliitis (unilateral or bilateral) occurs in fewer than 10% of acute cases but develops in half of patients with chronic severe disease (see the image below). Specifically ordering a radiograph of the sacroiliac joint is advisable. Such a film provides a more sensitive tunnel view than a routine film of the lumbosacral spine does.

Radiography of pelvis reveals bilateral asymmetric Radiography of pelvis reveals bilateral asymmetric sacroiliitis.

Syndesmophytes are asymmetric, paravertebral, bulky, discontinuous, comma-shaped ossifications that most commonly involve the lower thoracic and upper lumbar vertebrae (see the image below).

Radiograph in 40-year-old man shows nonmarginal sy Radiograph in 40-year-old man shows nonmarginal syndesmophytes predominantly in lower thoracic and upper lumbar spine.

Severe ankylosing spondylitis occurs in fewer than 5% of cases.


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