Table 6 General advice concerning algorithms for primary imaging of patients with autoinflammatory diseases
Disease | Presenting symptom/clinical question | Imaging modality |
|---|---|---|
FMF | Abdominal pain | - Abdominal radiograph and US - If negative aforementioned examinations and ongoing clinical concern: CT (oral and intravenous contrast) or MRI. Injection of gadolinium for MRI will depend on pre-contrast enhancement findings. - In case of chromic enteritis: MRE |
Joint pain | - Initial imaging: X-rays - Ultrasound: if suspicion of fluid or synovitis - MRI (contrast-enhanced): synovitis and osteochondral changes | |
TRAPS | Myositis/fasciitis | MRI (contrast-enhanced if suspicion of superimposed collection or osteomyelitis) |
MKD/HIDS | Cerebellar ataxia | MRI (contrast-enhanced if suspicion of cerebellitis) |
Joint pain | - Initial imaging: X-rays - Ultrasound: if suspicion of joint fluid or synovitis MRI (contrast-enhanced): synovitis and osteochondral changes | |
NOMID | CNS/hearing manifestations | MRI of brain and inner ear (contrast-enhanced) |
Bone and joint abnormalities | - Initial imaging: X-rays - Ultrasound: if suspicion of fluid or synovitis MRI (contrast-enhanced): for assessment of synovitis and osteochondral changes | |
MWS | Joint pain | - Initial imaging: X-rays - Ultrasound: if suspicion of fluid or synovitis MRI (contrast-enhanced): for assessment of synovitis and osteochondral changes |
Headache, CNS manifestations | MRI of brain (inner ear) (contrast-enhanced) | |
Blau | Joint manifestations | - Initial imaging: X-rays - Ultrasound: if suspicion of fluid or synovitis MRI (contrast-enhanced): for assessment of synovitis and osteochondral changes |
Hepatic and renal granulomas | Ultrasound of abdomen (including high-resolution scans) | |
Renal medullary nephrocalcinosis | Ultrasound of kidneys (including high-resolution scans) | |
Interstitial lung disease | CT of the chest (high resolution) | |
Stroke | MRI of brain (contrast-enhanced) | |
Lymphadenitis/swelling | Ultrasound (gray-scale) of region-of-interest (including color/power Doppler) | |
Large vessel vasculitis | US, MRA or CTA (in rare circumstances conventional angiogram | |
PAPA | Arthritis | - Initial imaging: X-rays - Ultrasound: if suspicion of fluid or synovitis MRI (contrast-enhanced): for assessment of synovitis and osteochondral changes |
Nephrocalcinosis | Ultrasound of kidneys (including high-resolution scans) | |
Intestinal lesions | Ultrasound (gray-scale and color/power Dopler), MRE | |
Perianal disease | MRI of the pelvis (with small field-of-view and use of gadolinium) | |
CNS vasculitis | MRI of the brain including MRA or CTA | |
DIRA | MSK manifestations | - Initial imaging: X-rays - Ultrasound: if suspicion of fluid or synovitis MRI (contrast-enhanced): for assessment of synovitis and osteochondral changes |
CNS vasculitis | MRI of the brain (contrast-enhanced) | |
NLRC4-MAS | Enterocolitis | Ultrasound of the bowel (with color/power Doppler) |
SIFD | Hepatosplenomegaly and Nephrocalcinosis | Ultrasound of abdomen |
HA20 deficiency | Joint pain/arthritis | - Initial imaging: X-rays - Ultrasound: if suspicion of fluid or synovitis MRI (contrast-enhanced): for assessment of synovitis and osteochondral changes |
IL10 def | Early onset inflammatory bowel disease | Ultrasound then MRE |
Perianal disease | MRI of the pelvis (with small field-of-view and use of gadolinium) | |
DADA2 | Stroke | MRI of the brain with MRA |
Vasculitis | US, MRA or CTA. Rarely, conventional angiogram | |
Aicardi-Goutieres syndrome | CNS manifestations | Brain CT and MRI (depending on the diagnosis, use of gadolinium). |
MSK manifestations | - Initial imaging: X-rays - Ultrasound: if suspicion of fluid or synovitis MRI (contrast-enhanced): for assessment of synovitis and osteochondral changes |