Role of C.T scan inearly detection of sacroiliitis and prognosis of patients with reactive arthritis [ReA]

ABSTRACT

The aim of this work was to study the role of CT in early sacroiliitis and to detect changes in the patients four months after treatment with a short course of antibiotics, thus pointed out to the prognosis of patients with ReA. Thirty patients with ReA were included in this study. Complete history, clinical examination, plain X-ray of sacroiliac [SI] joint [AP view of pelvis] and CT scan of SI joint before and after antibiotic therapy [minocycline capsules, 100 mg/twice daily for four weeks] in CT proven sacroiliitis were done. The clinical findings included inflammatory low back ache in 93% of the patients with typical characteristics such as morning back stiffness, heel tenderness in 70%, inflamed joint of knee [asymmetrical] in 76.6%, urethritis in 26.6% and eye inflammation in 26.6% mainly as conjunctivitis. CT scan of SI joint before treatment showed erosions and narrowing in 26.6% of patients with reactive arthritis. CT scan findings of SI joints after four months of treatment showed the same bone erosions and narrowing in patients with reactive arthritis who already had previous findings. CT scan is superior to radiography in the imaging of early bone changes