There are 4 sites in the posterior spine to assess for changes of AS.
- Facet Joints.
 - Superspinous Ligament.
 - Costovertebral joints.
 - Costo transverse joints.
Changes can be at 1 or more of these sites.
- Spinal changes start anteriorly and progress posteriorly.
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- All the examples are from chronic AS where bony fusion has occurred.
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- But these are also the areas to look at on MRI for the earlier changes of enthesitis and inflammation.
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