What is the role of MRI and CT scanning in the evaluation of ankylosing spondylitis (AS) in patients with bowel or bladder dysfunction?

Updated: Feb 02, 2021
  • Author: Lawrence H Brent, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Patients who develop bowel or bladder dysfunction should be evaluated immediately with MRI to assess for possible cauda equina syndrome secondary to spinal stenosis. Cauda equina syndrome is a surgical emergency necessitating decompression within 48 hours to prevent permanent loss of function.

Computerized tomography (CT) can be used to assess bony changes in patients with AS.  It is not routinely used because of its cost and radiation exposure.

CT scan of the pelvis in a patient with AS showing ankylosis of the sacroiliac joints.

CT scan of the pelvis in a patient with AS showing CT scan of the pelvis in a patient with AS showing ankylosis of the sacroiliac joints.

CT scan of the L-spine in a patient with AS showing bony syndesmophytes.

CT scan of the L-spine in a patient with AS showin CT scan of the L-spine in a patient with AS showing bony syndesmophytes.

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