Shiny corner sign (ankylosing spondylitis)

Changed by Daniel J Bell, 19 Mar 2024
Disclosures - updated 22 Aug 2023: Nothing to disclose

Updates to Article Attributes

Body was changed:

The shiny corner sign is is a spinal finding in ankylosing spondylitis, representing reactive sclerosis secondary to inflammatory erosions at the superior and inferior endplates (corners on lateral radiograph) of the vertebral bodies, which are known as Romanus lesions. Eventually, the vertebral bodies become squared (see vertebral body squaring for other causative entities).

Radiographic features

There is an ongoing international debate about specificity. Although axial spondyloarthritis is characterised by typical MR imaging features 5, these findings may not be totally specific and may be seen in degenerative or other spinal disorders as well 2, as all forms of spondyloarthritis may ultimately develop into ankylosing spondylitis in patients with longstanding disease 2.

Plain radiograph

Triangular regions of sclerosis are classically seen at the superior and inferior vertebral endplates anteriorly (corners). This occurs as a response to inflammatory Romanus erosions, which may be seen concomitantly with the sclerotic "shiny corners" 6.

MRI

MR imaging allows for the detection of Romanus lesions and shiny corners in both early and late spondyloarthritis, respectively 2.

In active disease, these lesions are depicted as reduced signal intensity of the rim of the endplate on T1 images images and as increased signal intensity on STIR images, representing representing bone marrow oedema or osteitis. At this stage, plain films appear normal or may show Romanus erosions. Later Later in the disease course, the epiphyseal ring can appear hyperintense on T1WI. Such hyperintense lesions represent circumscribed areas of post-inflammatory fatty bone marrow degeneration. Only at this stage are shiny corners depicted by conventional radiography - that is, long after inflammation has run its course.

  • -<p>The <strong>shiny corner sign</strong> is a spinal finding in <a href="/articles/ankylosing-spondylitis-1">ankylosing spondylitis</a>, representing reactive sclerosis secondary to inflammatory erosions at the superior and inferior endplates (corners on lateral radiograph) of the vertebral bodies, which are known as <a href="/articles/romanus-lesion-vertebral-bodies">Romanus lesions</a>. Eventually, the vertebral bodies become squared (see <a href="/articles/vertebral-body-squaring-differential">vertebral body squaring</a> for other causative entities).</p><h4>Radiographic features</h4><p>There is an ongoing international debate about specificity. Although axial spondyloarthritis is characterised by typical MR imaging features <sup>5</sup>, these findings may not be totally specific and may be seen in degenerative or other spinal disorders as well <sup>2</sup>, as all forms of spondyloarthritis may ultimately develop into ankylosing spondylitis in patients with longstanding disease <sup>2</sup>.</p><h5>Plain radiograph</h5><p>Triangular regions of sclerosis are classically seen at the superior and inferior vertebral endplates anteriorly (corners). This occurs as a response to inflammatory <a href="/articles/romanus-lesion-vertebral-bodies">Romanus erosions</a>, which may be seen concomitantly with the sclerotic "shiny corners" <sup>6</sup>. </p><h5>MRI</h5><p>MR imaging allows for the detection of Romanus lesions and shiny corners in both early and late spondyloarthritis, respectively <sup>2</sup>.</p><p>In active disease, these lesions are depicted as reduced signal intensity of the rim of the endplate on <a href="/articles/t1-weighted-image">T1</a> images and as increased signal intensity on <a href="/articles/stir">STIR</a> images, representing bone marrow oedema or osteitis. At this stage, plain films appear normal or may show Romanus erosions. Later in the disease course, the epiphyseal ring can appear hyperintense on T1WI. Such hyperintense lesions represent circumscribed areas of post-inflammatory fatty bone marrow degeneration. Only at this stage are shiny corners depicted by conventional radiography - that is, long after inflammation has run its course.</p>
  • +<p>The <strong>shiny corner sign</strong>&nbsp;is a spinal finding in <a href="/articles/ankylosing-spondylitis-1">ankylosing spondylitis</a>, representing reactive sclerosis secondary to inflammatory erosions at the superior and inferior endplates (corners on lateral radiograph) of the vertebral bodies, which are known as <a href="/articles/romanus-lesion-vertebral-bodies">Romanus lesions</a>. Eventually, the vertebral bodies become squared (see <a href="/articles/vertebral-body-squaring-differential">vertebral body squaring</a> for other causative entities).</p><h4>Radiographic features</h4><p>There is an ongoing international debate about specificity. Although <a href="/articles/axial-spondyloarthritis" title="Axial spondyloarthritis">axial spondyloarthritis</a> is characterised by typical MR imaging features <sup>5</sup>, these findings may not be totally specific and may be seen in degenerative or other spinal disorders as well <sup>2</sup>, as all forms of spondyloarthritis may ultimately develop into ankylosing spondylitis in patients with longstanding disease <sup>2</sup>.</p><h5>Plain radiograph</h5><p>Triangular regions of sclerosis are classically seen at the superior and inferior vertebral endplates anteriorly (corners). This occurs as a response to inflammatory <a href="/articles/romanus-lesion-vertebral-bodies">Romanus erosions</a>, which may be seen concomitantly with the sclerotic "shiny corners" <sup>6</sup>.&nbsp;</p><h5>MRI</h5><p>MR imaging allows for the detection of Romanus lesions and shiny corners in both early and late spondyloarthritis, respectively <sup>2</sup>.</p><p>In active disease, these lesions are depicted as reduced signal intensity of the rim of the endplate on <a href="/articles/t1-weighted-image">T1</a>&nbsp;images and as increased signal intensity on <a href="/articles/stir">STIR</a> images,&nbsp;representing bone marrow oedema or osteitis. At this stage, plain films appear normal or may show Romanus erosions.&nbsp;Later in the disease course, the epiphyseal ring can appear hyperintense on T1WI. Such hyperintense lesions represent circumscribed areas of post-inflammatory fatty bone marrow degeneration. Only at this stage are shiny corners depicted by conventional radiography - that is, long after inflammation has run its course.</p>

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