Shiny corner sign (ankylosing spondylitis)
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The shiny corner sign, also known as a Romanus lesion, is a spinal finding in ankylosing spondylitis inter alia. It represents small erosions at the superior and inferior endplates (corners on lateral radiograph) of the vertebral bodies, with surrounding reactive sclerosis. Eventually the vertebral bodies become squared (see vertebral body squaring for other causative entities).
There is ongoing international debate about specificity.Althoug axial spondyloarthritis is characterized 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.
Radiographic features
Plain film
The initial structural abnormalities described by Romanus and Yden already in the early 1950's are the earliest changes of spondylitis depicted on conventional radiographs. These changes consist of irregularities and erosions involving the anterior and posterior edges of the vertebral endplates and are also known as Romanus lesions 4.
MRI
MR imaging allows for the detection of Romanus lesions in both early and late spondyloarthritis 2.
In active disease, these lesions are depicted as reduced signal intensity of the rim of the endplate on T1WI MR images and as increased signal intensity on STIR images and represent bone marrow edema or osteitis and decreased signal on these sequences. At this stage plain films appear normal.
Later in the disease course, the epiphyseal ring can appear hyperintense on T1WI. Such hyperintense lesions represent circumscribed areas of postinflammatory, 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>, also known as a <strong>Romanus lesion</strong>, is a spinal finding in <a href="/articles/ankylosing_spondylitis">ankylosing spondylitis</a> inter alia. It represents small erosions at the superior and inferior endplates (corners on lateral radiograph) of the vertebral bodies, with surrounding reactive sclerosis. Eventually the vertebral bodies become squared (see <a href="/articles/vertebral_body_squaring">vertebral body squaring</a> for other causative entities).</p><p>There is ongoing international debate about specificity.<br>Althoug axial spondyloarthritis is characterized 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><h4>Radiographic features</h4><h5>Plain film</h5><p>The initial structural abnormalities described by Romanus and Yden already in the early 1950's are the earliest changes of spondylitis depicted on conventional radiographs. These changes consist of irregularities and erosions involving the anterior and posterior edges of the vertebral endplates and are also known as Romanus lesions <sup>4</sup>.</p><h5>MRI</h5><p>MR imaging allows for the detection of Romanus lesions in both early and late spondyloarthritis <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">T1WI</a> MR images and as increased signal intensity on <a href="/articles/stir">STIR</a> images and represent bone marrow edema or osteitis and decreased signal on these sequences. At this stage plain films appear normal.</p><p>Later in the disease course, the epiphyseal ring can appear hyperintense on T1WI. Such hyperintense lesions represent circumscribed areas of postinflammatory, 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>, also known as a <strong>Romanus lesion</strong>, is a spinal finding in <a href="/articles/ankylosing-spondylitis">ankylosing spondylitis</a> inter alia. It represents small erosions at the superior and inferior endplates (corners on lateral radiograph) of the vertebral bodies, with surrounding reactive sclerosis. Eventually the vertebral bodies become squared (see <a href="/articles/vertebral-body-squaring">vertebral body squaring</a> for other causative entities).</p><p>There is ongoing international debate about specificity.<br>Althoug axial spondyloarthritis is characterized 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><h4>Radiographic features</h4><h5>Plain film</h5><p>The initial structural abnormalities described by Romanus and Yden already in the early 1950's are the earliest changes of spondylitis depicted on conventional radiographs. These changes consist of irregularities and erosions involving the anterior and posterior edges of the vertebral endplates and are also known as Romanus lesions <sup>4</sup>.</p><h5>MRI</h5><p>MR imaging allows for the detection of Romanus lesions in both early and late spondyloarthritis <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">T1WI</a> MR images and as increased signal intensity on <a href="/articles/stir">STIR</a> images and represent bone marrow edema or osteitis and decreased signal on these sequences. At this stage plain films appear normal.</p><p>Later in the disease course, the epiphyseal ring can appear hyperintense on T1WI. Such hyperintense lesions represent circumscribed areas of postinflammatory, 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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