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Very early spondyloarthritis: where the inflammation in the sacroiliac joints starts
  1. M Bollow1,*,
  2. K-G A Hermann2,*,
  3. T Biedermann3,
  4. J Sieper4,
  5. M Schöntube5,
  6. J Braun6
  1. 1Department of Radiology, Augusta Hospital, Bochum, Germany
  2. 2Department of Radiology, Charité Medical School, Campus Mitte, Berlin, Germany
  3. 3Helios Clinics, 1st Children’s Hospital Berlin-Buch, Pneumology/Allergology Unit, Berlin, Germany
  4. 4Medical Department I, Rheumatology, Charité Medical School, Campus Benjamin Franklin, Berlin, Germany
  5. 5Helios Clinics, 2nd Children’s Hospital Berlin-Buch, Rheumatology Unit, Berlin, Germany
  6. 6St. Josephs Hospital, Rheumazentrum Ruhrgebiet, Herne, Germany
  1. Correspondence to:
    Dr K-G A Hermann
    Department of Radiology, Charité Medical School, Campus Mitte, Schumannstr 20/21, 10117 Berlin, Germany;


Involvement of the sacroiliac joints (SIJ) is a major and characteristic feature of the spondyloarthritides (SpA). In early ankylosing spondylitis and undifferentiated SpA (uSpA) sacroiliitis is the most common early clinical finding and the presumed first manifestation of the disease. Magnetic resonance imaging has proved useful for visualising inflammation in the SIJ in adults and children. Recently, initial localisation of the inflammation in the SIJ has been described in some detail, but it has not been completely defined to date—either in imaging or in histopathological studies. This is mainly owing to the lack of data in very early disease and the lack of follow up studies. Here we present a patient with early disease, which may augment our understanding of this stage of SpA.

  • AS, ankylosing spondylitis
  • IBP, inflammatory back pain
  • MRI, magnetic resonance imaging
  • SIJ, sacroiliac joint(s)
  • SpA, spondyloarthritides
  • uSpA, undifferentiated spondyloarthritides
  • spondyloarthritis
  • sacroiliac joints
  • early sacroiliitis
  • magnetic resonance imaging

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