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Best diagnostic clue:

SI joint erosion or ankylosis

First involves SI joints, bilaterally symmetric

May have erosions or sclerosis

Second T/L spine junction

May involve entire spine

“Bamboo spine”

Ossifications of:

paraspinous ligaments

outer fibers of annulus fibrosis

called syndesmophytes when bridging two adjacent vertebral bodies

Risk of fracture

Corner erosions lead to squaring of vertebral bodies

Supraspinous ligamentous calcification

T1 bright disk signal:

calcification or marrow replacement

If extensive:

Ank Spond

Multiple myeloma