Romanus lesion

{{Short description|Radiologic sign showing erosion of the vertebral endplates}}

In radiology, a Romanus lesion is the erosion of the anterior and posterior vertebral endplates in patients with an inflammatory spondyloarthropathy – such as ankylosing spondylitis or an enteropathic arthropathy.{{cite book |last1=Yochum |first1=Terry R. |last2=Rowe |first2=Lindsay J. |title=Essentials of Skeletal Radiology |date=2015 |publisher=Wolters Kluwer Health |isbn=9781451166484 |pages=1039–1040 |url=https://books.google.com/books?id=6v-JAQAACAAJ&q=romanus%20lesion%20yochum |accessdate=16 October 2018 |language=en}}{{cite journal |last1=Hermann |first1=Kay-Geert A. |last2=Althoff |first2=Christian E. |last3=Schneider |first3=Udo |last4=Zühlsdorf |first4=Svenda |last5=Lembcke |first5=Alexander |last6=Hamm |first6=Bernd |last7=Bollow |first7=Matthias |title=Spinal Changes in Patients with Spondyloarthritis: Comparison of MR Imaging and Radiographic Appearances |journal=RadioGraphics |date=May 2005 |volume=25 |issue=3 |pages=559–569 |doi=10.1148/rg.253045117 |pmid=15888608 |language=en |issn=0271-5333|doi-access=free }} The anterior erosion in particular causes a loss of anterior vertebral body concavity, causing the vertebra to display a squared contour or even a barrel-shape. Healing of the erosion results in a sclerotic increase in density causing what is known as a shiny corner sign,{{cite journal |last1=Bennett |first1=AN |last2=Rehman |first2=A |last3=Hensor |first3=EM |last4=Marzo-Ortega |first4=H |last5=Emery |first5=P |last6=McGonagle |first6=D |title=The fatty Romanus lesion: a non-inflammatory spinal MRI lesion specific for axial spondyloarthropathy. |journal=Annals of the Rheumatic Diseases |date=May 2010 |volume=69 |issue=5 |pages=891–4 |doi=10.1136/ard.2009.112094 |pmid=19666937 |s2cid=206863735 }} which can later result in syndesmophyte formation.{{cite book |last1=Schulthess |first1=Gustav K. |last2=Zollikofer |first2=Christoph L. |title=Musculoskeletal Diseases 2009-2012: Diagnostic Imaging |date=2010 |publisher=Springer Science & Business Media |isbn=9788847013780 |page=121 |url=https://books.google.com/books?id=eAWiGkyb-pwC&q=romanus+lesion |accessdate=16 October 2018 |language=en}} It is most easily diagnosed using MRI, compared to conventional radiography.

This type of erosion was initially described by Ragnar Romanus and Sven Ydén in a paper published in 1952.{{cite journal |last1=Romanus |first1=Ragnar |last2=Ydén |first2=Sven |title=Destructive and Ossifying Spondylitic Changes in Rheumatoid Ankylosing Spondylitis |journal=Acta Orthopaedica Scandinavica |date=8 July 2009 |volume=22 |issue=1–4 |pages=88–99 |doi=10.3109/17453675208988998 |pmid=13030181 }}