Sakroiliitis in der MRT – welche Informationen benötigen Radiologinnen und Radiologen und Rheumatologinnen und Rheumatologen?

Zusammenfassung

Bildgebung spielt bei der der axialen Spondyloarthritis (axSpA) eine Schlüsselrolle. Um eine präzise Diagnostik und der damit verbundenen Therapie zu ermöglichen ist hier eine effektive interdisziplinäre Kommunikation zwischen der Radiologie und Rheumatologie entscheidend. Dabei ist die Bereitstellung wichtiger Informationen zur Patientendemographie (Alter, Geschlecht), zur Anamnese (u. a. klinische axSpA-Features, Verdachtsdiagnose, Grund der Bildgebung), zur Klinik (Schmerzanamnese inklusive entzündlicher Charakter) und Labordaten (Entzündungsparameter, HLA-B27 Status) sowie eventuelle Kontraindikationen für Bildgebung (beispielsweise Klaustrophobie) für die Radiologie entscheidend, um eine gezielte Einordnung der Bildgebungsbefunde zu ermöglichen und damit letztendlich einen für die Rheumatologie wertvollen radiologischen Befund zu erstellen. Auf der anderen Seite soll der radiologische Befund alle wichtigen Informationen enthalten die für die Diagnose entscheidend sind. Dazu gehören die von der Rheumatologie bereitgestellten Patienteninformationen, technische Details der Untersuchung sowie die bedeutsamsten Bildgebungsbefunden. Zu diesen gehören das Knochenmarködem (Osteitis), Erosionen und Fettmetaplasien. Daneben sollen auch weitere Läsionen, die für oder gegen eine axSpA sprechen aufgeführt werden. Letztendlich sollen die wichtigsten Befunde in einer zusammenfassenden Beurteilung gebündelt werden und eine Einschätzung der bildgebenden Diagnose gegeben werden unter Angabe der diagnostischen Sicherheit. So trägt eine effektive interdisziplinäre Kommunikation zur optimalen Diagnosestellung und der damit verbunden Therapie bei.

Abstract

Imaging plays a key role in the diagnosis of axial spondyloarthritis (axSpA). Effective interdisciplinary communication between radiologists and rheumatologists is crucial for an accurate diagnosis and subsequent treatment. The radiologist requires essential information, including patient demographics (age, sex), medical history (e. g., clinical axSpA features, suspected diagnosis, reason for imaging), clinical details (pain history including inflammatory characteristics) and laboratory data (inflammatory markers, HLA-B27 status), as well as any contraindications for imaging (e. g., claustrophobia). This allows for an accurate interpretation of imaging findings and the provision of valuable radiological reports for the rheumatologist. On the other hand, radiological reports must include all important diagnostic information such as patient details provided by the rheumatologist, technical aspects of the examination and key imaging findings, including bone marrow edema (osteitis), erosions and fat metaplasia. In addition, other relevant imaging findings should be noted. Ultimately, a summary report should consolidate the most important findings and offer a diagnostic interpretation, including an indication of diagnostic confidence. Effective interdisciplinary communication is essential for achieving an accurate diagnosis and guiding appropriate treatment.

Schlüsselwörter

axiale Spondyloarthritis - Sakroiliitis - Bildgebung

Keywords

axialspondyloarthritis - sacroiliitis - imaging

Publication History

Received: 16 September 2024

Accepted: 01 November 2024

Article published online:
10 December 2024

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