Information Technology Reference
In-Depth Information
1 Overview
1.1 Spine Anatomy and Classi
cation of Arthritis
Vertebrae are the bony structure of the spine. The anterior parts of the vertebrae, the
vertebral bodies, are interconnected by the intervertebral disks. The outer layer of
the intervertebral disk is a dense
fibrous tissue, called the annulus
fibrosis. The
annulus
fibrosis and its adjacent vertebral body form the discovertebral joint.
The posterior part of the vertebra consists of the neural arch. At each vertebral level,
the inferior processes of one vertebra articulate with the superior processes of the
vertebra immediately below it, forming a facet joint (also known as the zygoapo-
physeal joint) on both the right and left sides. The neural arch forms the spinal
canal, containing the spinal cord, spinal nerves, spinal membranes, and spinal
fluid.
There are openings on the side at each vertebra level, called the intervertebral
foramen. The spinal nerves, originating from the spinal cord, exit the spinal canal
through the foramen. The vertebral bodies are lined with ligaments on the front and
back that provide stability. At the neural arch, the ligamentum
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avum connects
vertebrae to each other.
Arthritis is the common term used to describe pathological changes to joints and
their associated structures, including bones, cartilage, and ligaments. Depending on
whether the immune system is involved or not, arthritis can be categorized into two
main subtypes: in
ammatory. Several types of arthritis can
affect the spine. Osteoarthritis, a degenerative process often associated with aging,
is the most common type of non-in
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ammatory and non-in
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ammatory arthritis. The cervical spine and the
lumbar spine are often affected in osteoarthritis. When the spine is affected by
osteoarthritis, it is termed spondylosis. Degenerative changes occur in the inter-
vertebral disks as well, causing degenerative disk disease. Structural changes of the
vertebrae and the disks may lead to compression on the spinal cord or the spinal
nerve roots, causing a condition known as spinal stenosis. Rheumatoid arthritis is
the most common type of in
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ammatory arthritis. Although it primarily targets joints
of the extremities, rheumatoid arthritis may affect the cervical spine. In children,
juvenile idiopathic arthritis may damage the cervical spine in a similar fashion.
Ankylosing spondylitis is the prototypic inflammatory arthritis that primarily
involves the spine and the sacroiliac joints, with a prominent feature of slow
development of bony fusion among the adjacent vertebrae.
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1.2 Uses of Imaging in Diagnosis, Prognosis, Treatment,
and Assessment of Treatment Response
Plain radiography is the essential diagnostic tool for spinal arthritis, not only
because it can demonstrate much of the relevant pathological changes in the spinal
structures, but also because it is widely available and inexpensive. However, plain
