PMC3420786_01
(a) CT scan demonstrates erosions on the right SIJ (arrow). (b) CT scan demonstrates erosions on the left SIJ (arrow).
CRIM.RHEUMATOLOGY2011-195085.001.jpg
PMC3420786_01_CRIM.RHEUMATOLOGY2011-195085.001.jpg
fig1
The patient reported low inflammatory back pain for more than one year, good response to nonsteroid anti-inflammatory drugs (NSAIDs) and computer tomography imaging (CT) of bilateral sacroiliitis (grade 2), leading to the diagnosis of AS according to the ASAS criteria (Figure 1).
(a) represents 18F-FDG-PET/CT imaging showing multifocal hypermetabolic lesions of the sacroiliac joints, lungs and axillary, cervical, supraclavicular lymphadenopathy suggestive of systemic disease. (b) represents 18F-FDG-PET/CT imaging one year after antituberculosis treatment. All hypermetabolic lesions have been cleared, confirming efficient therapy of tuberculosis.
CRIM.RHEUMATOLOGY2011-195085.002.jpg
PMC3420786_01_CRIM.RHEUMATOLOGY2011-195085.002.jpg
fig2
The 18F-FDG-PET/CT revealed mediastinal, hilar pulmonary, supraclavicular and cervical bilateral hypermetabolic lymph nodes, hypermetabolic condensation in the right lung, multiple hypermetabolic lesions of axial skeleton (Figure 2(a)), in particular the thoracic spine, rib cage, and bilateral sacroiliac joints (Figure 3). The diagnosis of DT with axial skeleton, lung, and lymph node involvement was retained, and the patient was treated with Isoniazid 300 mg/d, Rifampicin 300 mg bid, Pyrazinamide 500 mg/d, and Ethambutol 400 mg qid. 18FDG-PET/CT was repeated after 1 year of treatment and showed total disappearance of the aforementioned lesions (Figure 2(b)).
The figure shows sacroiliac joint involvement as hypermetabolic lesions as seen on 18F-FDG-PET/CT. Left row: coronal CT, PET, and fused PET/CT slices. Right row: transverse CT, PET, and fused PET/CT slices.
CRIM.RHEUMATOLOGY2011-195085.003.jpg
PMC3420786_01_CRIM.RHEUMATOLOGY2011-195085.003.jpg
fig3
The 18F-FDG-PET/CT revealed mediastinal, hilar pulmonary, supraclavicular and cervical bilateral hypermetabolic lymph nodes, hypermetabolic condensation in the right lung, multiple hypermetabolic lesions of axial skeleton (Figure 2(a)), in particular the thoracic spine, rib cage, and bilateral sacroiliac joints (Figure 3).